Emergency medicine is part of the oldest fields in medicine, however, organized rescue services were at first recognizable in the end of the 19th century or rather in the beginning of the 20th century. In 1908, on the first international congress for rescue services in Frankfurt, the preclinical part was described as a special science, for which a medical instruction would be necessary. In spite of an initially general rejection of an involvement of physicians in the rescue services, it was ascribed to physicians very early to carry out first aid in accidents or sudden illness. In 1958 Kirschner demanded an early medical care at the scene of the accident. After the second world war, the public rescue services were mainly controlled by the occupying powers. The realization of the rescue service was delegated to aid agencies and the fire brigades. In 1956 Bauer was the pioneer of the emergency physician service by dispatching a physician to the scene of the accident with a bus. Out of this resulted the first emergency physician service, which was imitated in many big cities within the Federal Republic of Germany. Since the care for accident casualities stood in the foreground at the beginning, surgeons mainly carried out this service. As the system became more and more established, the characteristics of the patients changed and medical emergency patients increasingly constituted the population of patients. That leaded to a shift in the specialties of the physicians taking part in the emergency physician service. Regarding the qualification specific guidelines were released in 1983 by the federal chamber of physicians in Germany.