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Before the 1970s, emergency medical services (EMS) in the United States were largely fragmented and inconsistent. Most communities relied on volunteer ambulance services, fire departments, or police for emergency medical response, often with little formal training or equipment. Ambulance services were typically basic and focused on transportation rather than providing advanced medical care en route. The establishment of more organized and standardized EMS systems began to take shape in the 1970s, influenced by the findings of the 1966 "Accidental Death and Disability: The Neglected Disease of Modern Society" report.

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