The Emergency Department: A Historical Review
Prior to the 1960s, the nation's emergency rooms were in a general state of "neglect." However, as different factors placed an increasing demand for emergency care on hospitals, reforms were initiated. The result included improvements such as new systems, new personnel, and a new medical specialty. These changes have undoubtedly save many lives.
The typical emergency department today is a actually part of an entire emergency care system. This system consists of a community or regional network of services that provide for detection and reporting of medical emergencies, initial care at the scene, transportation and care enroute to a medical facility, and care of the patient until his is discharged, referred, or admitted for definitive medical care (AHA, 1972, p.viii).
Over the last 50 years, emergency health care has evolved considerably. Back in the 1940s, for example, the emergency room was often just an out of the way hospital area somewhere between the boiler room and the laundry (Mills, 1987, p. 81).
These early emergency departments tended to produce little revenue for the hospital. In fact, they were thought of as a necessary evil, existing only because of medicine's obligation to serve the unfortunate and the unscheduled. Shoddy financial support often meant that emergency room instruments and furnishings were castoffs from the operating rooms (Mills, 1987, p. 81). In addition, ambulance attendants received little training and there were no communication systems between the attendants and emergency department personnel. Emergency care areas at that time were simply not geared to accept life threatening emergencies (Rockwood et al., 1976, p. 299).
Moreover, the early departments were usually only staffed by nurses (Mills, 1987, p. 81). Back up medical personnel would be summoned as needed (Cameron et al., 1976, p. 1176). Even then though, medical perso...