In 1966, a National Academy of Science's National Research Council white paper described inadequacies in the emergency health care available in the United States. Entitled “Accidental Death and Disability: The Neglected Disease of Modern Society,” this paper cited a diversity or lack of standards for many aspects of emergency medical services (EMS) and a general absence of a systemized approach.

Federal response in the early 1970s, through the National Highway Traffic Safety Administration and the EMS System Act of 1973, addressed the fragmented delivery of EMS, and set standards for planning and developing such services within the context of an EMS system. The System Act addressed the primary prevention of injury and acute, critical illness as well as methods for comprehensive intervention, from system access and prehospital care through stabilization and rehabilitation, in those cases where primary prevention fails.