[Emergency medicine yesterday]

Abstract

It was only during the early sixties that emergency medicine started developing both world wide and especially in Germany. Although it had been realised already in the 19 th century that absence of treatment for a period after infliction of a wound had a crucial effect on recovery, and in spite of the fact that in 1938 Kirschner had stressed the need for preclinical medical care, results of research on the pathophysiology of sudden death were not available until 1960. At the same time it became possible to develop measures and methods enabling to preserve the vital functions essential for survival already at the site of an accident and during transportation or to restore them after circulatory arrest. Basing on these realisations, an emergency sequence of survival measures was worked out and within a period of 20 years the prerequisites were translated into reality that ensured a chain of emergency measures including the necessary organisational, structural and personal requirements for immediate and effective action, including the requisite means of transportation and the essential diagnostic and therapeutic equipment. The following article describes both the positive developments and the deficits that still existed in 1990. German anaesthesiology has made highly decisive contributions to the present and internationally recognised efficiency of emergency medicine and emergency intensive-care services.