The origin of all emergency medical services lies in the emergency
             techniques of Cardio Pulmonary Resuscitation made possible by the
             two Maryland pioneers in pre-hospital emergency care. In 1958, Johns
             physician Peter Safar published a study in the New England Journal of
             evaluated emergency artificial respiration techniques, which at that time,
             repeatedly raising the arms of the patient over the head to induce
             Specifically, Safar investigated the efficacy of the chest-pressure/arm
             compared to mouth-to-mouth and mouth-to-airway techniques, establishing the
             overwhelming superiority of the latter over the former (Safar).
             At approximately the same time, another Johns Hopkins physician,
             Kouwenhoven, was engaged in research into the development of effective
             defibrillation equipment, when he noted the dramatic effects of external
             applied to the chest compartment on the arterial pressure. His actual
             concerned the application of defibrillation panels on dogs, but during the
             establishing the proper paddle pressure, he discovered the value of
             chest compartment externally. Shortly thereafter, the National Academy of
             combined the findings of the two Maryland physician into a standardized
             Cardio Pulmonary Resuscitation rescue technique, now in use throughout the
             The first documentation in medical literature of a pre-hospital life-
             of CPR for acute cardiac arrest occurred in 1960, in Maryland as well.
             fighters had received CPR training at Johns Hopkins, which they implemented
             field, on a patient in full cardiac arrest. At that time, defibrillation
             been adapted to practical mobile use by first responders, so the patient
             treated with CPR at the scene and then rushed to Johns Hopkins, where he
             successfully defibrillated, eventually making a complete recovery (Bass).
             The development of CPR by Maryland physicians at Johns Hopkins
             the original basis for all first responder, ...