During the French Revolution, after seeing the speed with which the carriages of the French flying artillery maneuvered across the battlefields, French military surgeon Dominique Jean Larrey applied the idea of ambulances, or "flying carriages", for rapid transport of wounded soldiers to a central place where medical care was more accessible and practical. Larrey operated ambulances with trained crews of drivers, corpsmen and litter-bearers and had them bring the wounded to centralized field hospitals, effectively creating a forerunner of the modern MASH units. Dominique Jean Larrey is sometimes called the Father of Emergency Medicine for his strategies during the French wars. Emergency medicine as an independent medical speciality is relatively young. Before the 1960s and 1970s, hospital emergency departments (EDs) were generally staffed by physicians on staff at the hospital on a rotating basis, among them family physicians, general surgeons, internists, and a variety of other specialists. In many smaller emergency departments, nurses would triage patients, and physicians would be called in based on the type of injury or illness. Family physicians were often on call for the emergency department and recognized the need for dedicated emergency department coverage. Many of the pioneers of emergency medicine were family physicians and other specialists who saw a need for additional training in emergency care.[11] During this period, physicians began to emerge who had left their respective practices to devote their work entirely to the ED. In the UK in 1952, Maurice Ellis was appointed as the first "casualty consultant" at Leeds General Infirmary. In 1967, the Casualty Surgeons Association was co-established with Maurice Ellis as its first president.[12] In the US, the first of such groups managed by Dr James DeWitt Mills in 1961, along with four associate physicians; Dr Chalmers A. Loughridge, Dr William Weaver, Dr John McDade, and Dr Steven Bednar, at Alexandria Hospital in Alexandria, Virginia, established 24/7 year-round emergency care, which became known as the "Alexandria Plan".[13] Maurice Ellis Blue Plaque Unveiling It was not until Dr. John Wiegenstein founded the American College of Emergency Physicians (ACEP)(https://www.annemergmed.com/article/S0196-0644(04)01836-0/fulltext#relatedArticles) the recognition of emergency medicine training programs by the AMA and the AOA, and in 1979 a historic vote by the American Board of Medical Specialties that emergency medicine became a recognized medical speciality in the US.[14] The first emergency medicine residency program in the world began in 1970 at the University of Cincinnati.[15] Furthermore, the first department of emergency medicine at a US medical school occurred in 1971 at the University of Southern California.[16] The second residency program in the United States soon followed at what was then called Hennepin County General Hospital in Minneapolis, with two residents entering the program in 1971.[17] 1961: James Mills Jr MD started full time ED practice in Alexandria VA. At this time there are only hundreds of ED physicians in the country. 1966: Trauma surgeon report calling ed "the weakest link in the chain of hospital care". THe National Academy of Sciences released Accidental death and disability:the neglected disease of modern society which noted injuries killed 107,000 yearly. 1968: Dr. John Wiegenstein and Dr. Eugene Nakfoor (lansing MI) founded ACEP 1969: ACEP's first scientific assembly with 128 physicians attending 1970: FIrst ER residency (Cincinatti General). First resident was Bruce Janiak. Dr. Herbert Flessa was a young hematologist that wanted to improve emergency care. Initially approved under family medicine. 2 year certificate program. 1972: University of Louisville, University of Chicago (rosen) 1975: 31 Residencies 1979: ER named 23rd medical specialty by American Board of Medical Specialties 1980: First board certified ED physicians The ER began after the second world war. Fewer home visits, office hours, urban sprawl made it harder to deliver quality care. Hospital based medicine increased. Usually a small room with a single nurse. Currently there are 48,835 active emergency physicians. Median age is 50. Sources: Emergency Medicine Documentary: https://www.emra.org/about-emra/publications/legacy-documentary/#247365documentary https://www.acep.org/static/globalassets/resources/content/horizontal-timeline/index.html https://www.history.com/news/americans-once-avoided-the-hospital-at-all-costs-until-ers-changed-that https://elischolar.library.yale.edu/cgi/viewcontent.cgi?article=1056&context=ymtdl Mike AKA Dr. Provolone
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