Randolph Mantooth, known for playing paramedic Johnny Gage on the “Emergency!” TV series in the 1970s, died July 9 at age 80:
Mantooth broke out in 1972 when he was cast in “Emergency!,” which introduced the profession of paramedics to the public. He co-starred with Kevin Tighe in the popular NBC series which ran for six seasons, and performed most of his own stunts.
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He played his “Emergency!” character Johnny Gage on other shows such as “Adam-12,” and remained an advocate for firefighters, paramedics and EMTs throughout his life.
The modern EMS system was instituted and funded in large part by the federal government through the Highway Safety Act of 1966 and the EMS Act of 1973:
In 1910, the American Red Cross began providing first-aid training programs across the country, initiating an organized effort to improve civilian bystander care. During World Wars I and II, further advances were made in EMS, although typically these were not replicated in the civilian setting until much later (Pozner et al., 2004). Following World War II, city EMS activities were for the most part run by municipal hospitals and fire departments. In smaller communities, funeral home hearses often served as ambulances because they were the only vehicle capable of transporting patients quickly in stretchers. With the advent of federal involvement in EMS in the early 1970s and the articulation of standards at the state and regional levels, these EMS providers were gradually replaced by others, including third-service providers, fire departments, rescue squads, and private ambulances (NHTSA, 1996).
By the late 1950s, prehospital emergency care in the United States was still little more than first aid (IOM, 1993). Around that time, however, advances in medical care began to spur the rapid development of modern EMS. While the first recorded use of mouth-to-mouth ventilation had been in 1732, it was not until 1958 that Dr. Peter Safar demonstrated it to be superior to other modes of manual ventilation. In 1960, cardiopulmonary resuscitation (CPR) was shown to be efficacious. These two clinical advances led to the realization that rapid response of trained community members to cardiac emergencies could improve outcomes. The introduction of CPR and the development of portable external defibrillators in the 1960s provided the foundation for advanced cardiac life support (ACLS) that fueled much of the development of EMS systems in subsequent years.
In 1965, the President’s Committee for Traffic Safety published the report Health, Medical Care and Transportation of the Injured. The report recommended a national program to reduce highway deaths and injuries. The following year, the National Academy of Sciences (NAS) and National Research Council (NRC) released Accidental Death and Disability: The Neglected Disease of Modern Society (NAS/NRC, 1966). That report emphasized that the health care system needed to address injuries, which at the time were the leading cause of death for those aged 1–37. It noted that in most cases, ambulances were inappropriately designed, ill-equipped, and often staffed with inadequately trained personnel. For example, the report called attention to the fact that at least 50 percent of ambulance services nationwide were being provided by morticians.
The report contained a total of 29 recommendations, 11 of which applied directly to prehospital EMS (Delbridge et al., 1998). These included recommendations to (1) develop federal standards for ambulances (design, construction, equipment, supplies, personnel training and supervision); (2) adopt state ambulance regulations; (3) ensure provision of ambulance services applicable to the conditions of the local government; (4) initiate pilot programs to evaluate automotive and helicopter ambulance services in sparsely populated areas; (5) assign radio channels and equipment suitable for voice communications between ambulances and emergency departments (EDs) and other health-related agencies; and (6) develop a single nationwide telephone number for summoning an ambulance. The report also laid out a vision for the establishment of trauma systems as we know them today.
In addition to the momentum that had been provided by the President’s Commission, support for the NAS/NRC report was fueled by surgeons with military experience in Korea and World War II who recognized that the trauma care available to soldiers overseas was better than the care available in local communities. In 1966, Congress passed the Highway Safety Act, which led to the formation of the National Highway Traffic Safety Administration (NHTSA) within the Department of Transportation (DOT).


