Nutshell? Hmmmm. Off the top of my head: Then- needed hospital orders to insert an esophageal airway (EOA, rarely used today), Now- can place an endotracheal tube (much better) with no base contact. Then- hospital order to start an IV line, Now- IVs started all time with no contact. Then- oxygen occasionally used on patients, Now- nearly every patient receives O2. Then- a cardiac rhythm strip needed to be sent to the hospital to be read, Now- medics routinely interpret and treat arrhythmias with no physician assistance. Then- very few medications for patient treatment, Now- most medics can use at least 15 to 20 meds in the pre-hospital setting. Is that enough info?