Ambulances were first used on a battlefield around 1487. However, they went in after fighting was over, to pick up any wounded soldiers that had survived. These ambulances were usually farm carts used to bring wounded soldiers to makeshift hospitals or medical tents.
During the Civil War, the Office of Surgeon General was set up by the War Department to improve medical treatment of soldiers. One of the early Surgeon Generals, William Hammond, designed an ambulance wagon for the wounded and made sure that there was one ambulance for every 150 soldiers. Hammond’s system proved so efficient that a battlefield could be cleared of wounded by the end of a day.
In 1869, a former Union Army surgeon, Edward Dalton, set up an ambulance service at Bellevue Hospital in New York City. Dalton knew that the faster a patient was brought to the hospital, the better their chances of surviving. Bellevue’s new ambulances were stocked with medical equipment, such as splints, morphine and stomach pumps, and staffed by doctors. Teams of horses were kept on-call and an ambulance could be sent out within 30 seconds.
By 1900, horse ambulances were replaced with motorized ones, which had electric lights, a cot and seats for attendants. They also had a gong to alert other traffic and pedestrians. By World War I, all ambulances were stocked with traction splints, to keep patients with fractures stabilized.
After a bad train crash in Great Britain (the Harrow and Wealdstone rail crash), a government enquiry found that many victims might have been saved if better equipment had been available at the scene. Ambulances began to be fitted with medical equipment, such as defibrillators and oxygen tanks, which previously were only available in a hospital. Modern ambulances now resemble an emergency room in miniature and are staffed by trained medical emergency response personnel.