FOREWORD
The sight of an injured we)man lying in the middle of a busy
intersection in the heart of Manhattan on a snowy day in 1976
for fifteen minutes before the wail of an ambuhmce siren ap-
proached led an officer of the Macy Foundation to propose that
the Board of Directors initiate a progranl to improve emer-
gency medical services in New York City.
We are not a study-oriented tbundation; we prefer action
programs. We therefore concluded that aIT ot~jective investiga-
tion and evaluation conducted under the aegis of an important
academic department would stimulate action to upgrade pre-
hospital emergency care on a citywide basis. This assignment
was given to G. Thomas Shires， M.D.， Lewis Atterbury Stimson
Professor and Chairman of the Department of Surgery， Corncll
University Medical College.
A comparison of the data assembled by Dr. Shires and his
associates on the situation in New York City with that of sixleen
oflmr cities across the country produced a series of shock waves
that led the mayor of this city to institute major changes in
policy and practices.
As a resuh of that study the fimndation decided thal a
national perspective on EMS would be valuable， and a confer-
ence for that purpose was convened on 9 to 11 September 1979.
This report not only. contains contributions from physi-
cians active in the field in the United States， but reports from
Scandinavia and Japan on the status of EMS in those countries.
John Z. Bowers
President
6June 1980
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