stat
Milestones //
Mobile Aid
infographic //
Genes in a Haystack
by rachael moeller gorman // infographic by flying chilli
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protomag.com // summer 07
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Throughout centuries of
warfare, soldiers could lie
wounded on the field until the
battle ended before receiving
necessary care. That was bad
enough in the era of swords and
arrows, but the introduction
of gunpowder during the
fourteenth century caused the
death rate to skyrocket. Still,
it took another 400 years and a
clever French army surgeon to
devise a better system.
Dominique-Jean Larrey
created relatively lightweight
two- and four-wheel horsedrawn wagons to transport the
injured in the heat of battle.
Larrey called his invention,
which he conceived 215
years ago, in 1792, the flying
ambulance. (He adopted the
name from ambulancia, a term
for “field hospital” credited
to Spain’s Queen Isabella and
derived from the Latin ambulare,
“to walk.”) Larrey’s superiors—
including Napoléon Bonaparte,
who became commander in chief
of the French army in 1795—
took notice and charged Larrey
with spreading the use of the
ambulance throughout the army.
As Napoléon’s campaign
broadened, Larrey modified his
flying ambulance to operate
on various types of terrain.
Ambulances were drawn
by camels in the Egyptian
desert and by mules in the
mountainous regions of
Spain, Poland and Russia. The
ambulances’ success as well as
Larrey’s skill as a surgeon—he
could amputate an arm in
17 seconds—earned him a
promotion to surgeon general.
Although Larrey’s invention
caught on with other armies,
it wasn’t until 1869 that the
first hospital-based ambulance
service began, at New York
City’s Bellevue Hospital.
The horse-drawn carriages
responded to more than 1,400
calls the first year. Thirty years
later, Chicago’s Michael Reese
Hospital introduced a motorized
ambulance that could transport
patients as quickly as a good
horse: about 16 miles per hour.
Larrey, whose wagons were
equipped with horsehair-stuffed
mattresses, could scarcely have
imagined how his invention
would evolve. Ambulances
today can be outfitted with
mobile electrocardiographs
that transmit readings over
cell phones; defibrillators that
provide feedback on the speed
and strength of a paramedic’s
CPR compressions; and pupilmonitoring devices that register
the neurological status of an
unconscious patient. EMTs can
use Web-based data to overlay
variables, including weather
patterns, traffic jams and
hospital bed counts, to decide
how and where to take patients,
says Robert Bass, an emergency
physician and executive director
of the Maryland Institute for
Emergency Medical Services
Systems in Baltimore.
Down the line, Bass foresees
greater regionalization of care,
as EMTs, using ultrasound
images, blood scans and devices
that recognize increased
intracranial pressure, are able
to triage patients en route to the
specialty hospital best suited to
manage their condition. “It’s not
unrealistic that ambulances will
have these capabilities,” Bass
says. “It’s happening so fast.”
sUmmer 07 //
11
protomag.com