<P> In the late 1960s, Dr. R Adams Cowley was instrumental in the creation of the country's first statewide EMS program, in Maryland . The system was called the Division of Emergency Medical Services (now known as the Maryland Institute for Emergency Medical Services and Systems). Also in 1969, Cowley obtained a military helicopter to assist in rapidly transporting patients to the Center for the Study of Trauma (now known as the R Adams Cowley Shock Trauma Center), a specialized hospital that he had started for the purpose of treating shock . This service was not only the first statewide EMS program, but also the beginning of modern emergency medical helicopter transport in the United States . </P> <P> The first civilian hospital - based medical helicopter program in the U.S., Flight For Life Colorado, began in 1972 with a single Alouette III helicopter, based at St. Anthony Central Hospital in Denver, Colorado . </P> <P> National EMS standards for the US are determined by the U.S. Department of Transportation and modified by each state's Department of EMS (usually under its Department of Health), and further altered by Regional Medical Advisory Committees (usually in rural areas) or by other committees, or even individual EMS providers . In addition, the National Registry of Emergency Medical Technicians, an independent body, was created in 1970 at the recommendation of President Lyndon B. Johnson in an effort to provide a nationally accepted certification for providers and a nationwide consensus on protocols . Currently, National Registry certification is accepted in some parts of the U.S., while other areas still maintain their own, separate protocols and training curricula . </P> <P> A significant event in the development of modern standards of care in the U.S. was a report published in 1966 by the National Academy of Sciences entitled "Accidental Death and Disability: The Neglected Disease of Modern Society", commonly referred to as "the White Paper ." In this study, it became apparent that many of the deaths occurring every day were unnecessary, and could be prevented through a combination of community education, stricter safety standards, and better pre-hospital treatments . </P>

List the five types of emergency medical services in the united states