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Pioneers of Paramedicine Honored in L.A.


Saturday night, four of the most influential physicians in EMS history were honored at the Pioneers of Paramedicine Lifetime Achievement Awards Gala, hosted by the County of Los Angeles Fire Museum in the Crystal Ballroom of the historic Millennium Biltmore Hotel in Los Angeles.

The event honored Eugene Nagel, MD, medical director for the City of Miami Fire Dept from 1964-1974, Leonard Cobb, MD, who established the first paramedic-staffed mobile intensive care units (Medic One) in Seattle in the late '60s, J. Michael Criley, MD, who founded the Los Angeles County Paramedic Program in 1969 and the Los Angeles County Paramedic Training Institute at Harbor General Hospital in Los Angeles, and Walter Graf, MD, founder of the Daniel Freeman paramedic training program in Los Angeles and developer of one of the first MICU services in the U.S.

The evening started with paramedic students from Riverside Community College, dressed sharply in Class A uniforms, escorting arriving guests into a pre-banquet reception in the hotel’s beautiful Tiffany Ballroom.

Randolph Mantooth, who starred as paramedic Johnny Gage on the hit TV series Emergency!, and an active member of the board of the County of Los Angeles Fire Museum, was there. Board members from the County of Los Angeles Fire Museum and LA County Fire Chief P. Michael Freeman welcomed guests as they arrived. Kevin Tighe who starred in Emergency! with Mantooth, made a surprise appearance at the cocktail party prior to his evening performance in a play several blocks away.

Mantooth welcomed more than 250 attendees to the event. He told the attendees that the Emergency! series catapulted paramedicine into every living room in the U.S. and into the thought process of government leaders who soon demanded that a similar level of ALS system be implemented in their community. But Mantooth, ever aware of the show’s history and humble beginnings, was also quick to point out the TV show was mirrored on the efforts of several EMS systems being developed and expanding in scope at the beginning of 1970 and said the true credit belonged to the four physicians being honoured at the inaugural Pioneers of Paramedicine event.

He told the crowd that the passing of EMS visionaries like Peter Safer, MD and James O. Page made him and fellow County of Los Angeles Fire Museum board member, Nancy McFarland, realize that EMS was passing up the opportunity to record and preserve its history by not capturing the work, words and wisdom of the early pioneers of EMS. So the County of Los Angeles Fire Museum decided to establish a project that would record the historical contributions of key EMS leaders in an effort to preserve their stories for future generations of EMS providers to view and learn from.

The formal program began with Mantooth and UCLA’s Baxter Larmon, director of the Center for Prehospital Care at UCLA, sharing emcee duties, welcoming the crowd and explaining the goals of the Pioneer of Paramedicine project. The two also introduced the other members of the event’s planning committee: Nancy McFarland, Kristen Connors and Joe Covelli.

Connors, Mantooth’s manager and wife, a long-time event planner, did a masterful job of coordinating the event like an incident commander, with a radio on her hip, a smile on her face and directions to participants that moved the program along like the workings of a fine Swiss clock.

Mantooth also recognized and thanked the event’s founding sponsors, Masimo Corporation and Philips Healthcare; program sponsor ZOLL; Premier Media Sponsor, JEMS; and Media Sponsor, EMS Magazine. He noted that an event of this magnitude would not have been possible without the support of these generous and dedicated sponsors.

He personally thanked Joe Kiani, Masimo Corporation chairman and CEO, and Jason Maravelias, director of marketing North America for Philips Healthcare for believing in the project and providing financial support to make it happen.

Nancy McFarland, the dynamic and dedicated Pioneers Committee Chair who shared Mantooth’s vision for the project, pointed out that the Pioneers of Paramedicine Project is dedicated to the memory and work of James O. Page, JEMS founding publisher, a former LA County Fire Department Battalion Chief, technical advisor to the Emergency! TV Series, and former member of the board of the County of Los Angeles Fire Museum.

McFarland also thanked the many national organizations that endorsed the project, including: NAEMSP, NAEMSE, UCLA Health System, NAEMT, the IAFF and the IAFC.

But the highlight of the evening was the introduction and recognition of each of the distinguished honorees. Each was introduced by a surprise guest who knew them from the early days of their EMS career, the most notable being Seattle’s current and long-time Medical Director Michael K. Copass, MD , who introduced Seattle Medic One pioneer, Leonard Cobb.

Leonard Cobb, MD, was founding medical director of Seattle’s Medic One Program and served in that role for nearly 25 years. Cobb told the attendees that he was fortunate to have visionary Seattle Fire Chief Gordon Vickery’s support in developing and implementing a program that was totally new in concept and format.

Cobb noted that, while physicians helped staff Medic One units in the first 18 months of the Seattle program, he soon realized that the fire fighters trained as paramedics could ably handle all the ALS tasks assigned to them without a physician at their side. So he approached Vickery with the concept and Vickery gave him full support in making the change.

Cobb credited that action, as well as the implementation of an abbreviated, community-wide citizen CPR program, with the outstanding results soon realized in out-of-hospital resuscitations.

Eugene (Gene) Nagel, MD, who helped craft the Miami Fire Department’s paramedic program, also acknowledged the support received from fire officials who realized the EMS was natural extension of the emergency work already carried out by their crews. Nagel said that, with strategically located resources and rapid response times, the Miami crews were poised to take on the demands of EMS.

In the late '60s, Nagel and his colleagues at the University of Miami Medical School conducted the first paramedic program at the University of Miami. With a degree in electrical engineering as part of his early training, Nagel developed the first telemetry unit in the U.S. in the garage of his home and assisted a small California manufacturer, Biocom Corporation, in developing a modulator that had sufficient shielding and bypass capabilities to overcome the interference that radio signals produced in the transformation of an ECG’s millivolts into an audible tone for radio transmission.

In March of 1967, Miami's new "paramedics" began to routinely transmit ECGs to Jackson Memorial Hospital using combined radio/telemetry units that weighed in at 54 pounds but were battery-powered and "portable."

Nagel said that he was aware of the ALS development being carried out in Seattle, Los Angeles, Columbus, Ohio and other areas of the country, but that he and his contemporaries at the time did not really know each other when they were innovating and developing their local programs. Each of the honorees however had a common thread between them; they had each heard or read about the early prehospital efforts of Dr. Frank Pantridge in Belfast, Northern Ireland. Each was inspired by his work and his program’s success and began to figure a way to develop a similar program, but through use of civilian personnel.

J. Michael Criley, MD, served as Chief of the Division of Cardiology at Harbor-UCLA Medical Center for 20 years. He founded the Los Angeles County Paramedic Program in 1969, and the Los Angeles County Paramedic Training Institute is named in his honor. He has been on the full time faculty at Harbor-UCLA Medical Center for 42 years and is emeritus professor of Medicine and Radiological Sciences at the UCLA School of Medicine.

The initial program Criley conducted at Harbor General Hospital consisted of 18 firefighters, 12 from the Los Angeles County Fire Department and six from Los Angeles City Fire Department.

He, like his fellow honorees, convinced their fire chiefs that prehospital medicine could be performed by well trained civilian personnel, but pointed out that one obstacle stood in their way; the lack of enabling legislation that would allow civilians to operate in the field. So Criley and Los Angeles County Supervisors travelled to Sacramento to enlist the support of their state legislature, and ultimately then Governor Ronald Reagan, to adopt the important legislative piece of the puzzle.

He told the banquet guests that Reagan initially was reluctant to support the proposed legislation, but changed his mind when he leaned that the paramedic response systems would be allowed to cross county lines to render care in neighboring EMS districts. It turns out that Reagan’s father died when an ambulance service in his home state was prohibited from crossing county boundaries and assist his father when he collapsed and was in need of emergency care.

Criley credited that important fact with gaining Reagan’s support for the famous The Wedsworth-Townsend Act which went on to become the model legislation for many other states. Reagan went on to become president and later supported national legislation that helped establish EMS throughout the country.

Walter Graf, MD, was a cardiologist at Daniel Freeman Hospital who became an early EMS supporter and strong proponent of a mobile care unit for Los Angeles. With grant funds provided by the local chapter of the American Heart Association, he launched a Mobile Coronary Care Unit based on the Pantridge model in 1969 -- a fully equipped vehicle staffed by nurses who were empowered to start intravenous infusions, administer drugs and defibrillate.

Established by Daniel Freeman Hospital in 1970 as one of the first paramedic training programs in the nation, the program joined forces with the UCLA Center for Prehospital Care in 1999. The Daniel Freeman program, under Graf’s leadership became the first nationally accredited paramedic education programs in the country.

Graf, like his colleagues, acknowledge the tremendous support received from nursing educators, supervisors and staff during the early days of paramedicine, but also realized that, for a prehospital program to sustain itself on a long-term basis, fire fighters and other civilian personnel need to be trained. Graf became legendary for his ability to transfer critical concepts and medical material to paramedic students and still inspires classes at Daniel Freeman, visiting their classes and attending their graduation ceremonies.

Mantooth told the attendees that both Criley and Graf were responsible for providing solid medical advice not only to their paramedic students but to the Emergency! TV series, making it realistic and, most important, factual.

The County of Los Angeles Fire Museum will put the finishing touches on the personal interviews conducted with this year’s honourees and announce the Pioneers of Paramedicine film premier when it is finalized. Watch for updates in JEMS, on jems.com and JEMS Connect.


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