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Los Angeles County: Pioneer in Emergency Medical Services

Los Angeles Fire Department Paramedic Unit

Los Angeles Fire Department paramedic unit. los Angeles Almanac Photo.

When the TV series Emergency! first aired in 1972, dramatizing the real experiences of Los Angeles County Fire Department paramedic units, it was the first time most Americans had heard the term “paramedic.” At the time, there were only six actual paramedic units operating anywhere in the nation– in Los Angeles County, Miami and Seattle. By 1977, however, when the television series ended, paramedic units were operating in all 50 states. Not only were Los Angeles County firefighter paramedics among the first in the nation, their portrayal in the television series promoted the introduction of firefighter emergency medical services nationwide.

Los Angeles County’s firefighter paramedic units can be traced back to Dr. Walter S. Graf, a Los Angeles cardiologist, who, during the 1960s, was concerned by the number of heart attack victims dying en route to hospitals. Ambulance crews typically provided little more assistance to patients than would a taxi. Graf had been an Army physician and was familiar with Army efforts to improve the survival of wounded soldiers being transported from the battlefield to field hospitals. He believed that heart attack victims in Los Angeles could have a better chance of survival if life-saving emergency medical care and equipment were available when being transported. This was already being studied and tested in other cities in America and in Germany and Ireland.

Los Angeles County’s First Mobile Emergency Care Unit

In 1969, Graf, as chief of staff at Daniel Freeman Memorial Hospital in Inglewood (closed in 2007) and with the support of the Los Angeles County Heart Association (Graf was president at the time), organized a “Mobile Critical Care Unit” or “Heart Car” to deploy from the hospital. The unit operated in a converted Chevy van, staffed with a registered nurse and equipped with a cardiac monitor, defibrillator, and radio communication equipment.

Los Angeles County’s First Firefighter Paramedics

First Harbor General Hospital Paramedic Graduates, 1969

First Harbor General Hospital paramedic graduates, 1969. Photo from brochure for EMS 50th Anniversary Celebration.

At the same time, Los Angeles County Supervisor Kenneth Hahn, a patient of Graf and believer in improved emergency medical services, convinced fellow Board of Supervisor members to approve a “Mobile Intensive Care Paramedic” training program for Los Angeles County firefighters that would expand emergency medical services in the county. Dr. Michael Criley and Critical Care Nurse Carol Bebout at Harbor General Hospital (present-day Harbor-UCLA Medical Center) in Torrance oversaw the formation of 17 Los Angeles County and Los Angeles City firefighters into an emergency medical response unit that deployed from a station on the hospital grounds. Their Plymouth station wagon (repainted red from its original Department of Forestry green) became the first official Los Angeles County Fire Rescue Unit in service. The unit had direct radio communication with the hospital, but carried no telemetry equipment for transmitting heart activity data. Within days of entering service, however, the unit logged its first life-saving event, resuscitating Clement Demuth at a restaurant after he went into full cardiac arrest after choking on food.

The firefighters in the unit, however, were mostly restricted to transporting and assisting a nurse from the Harbor County Hospital’s Coronary Care Unit who had to be picked up before they could head to a call. Per state law at the time, only a physician or nurse could administer medications and operate a defibrillator.

Rescue Heart Unit, 1969

Los Angeles County Rescue Heart Unit at Harbor County Hospital, 1969. Photo from brochure for EMS 50th Anniversary Celebration.

The Fight for Real Paramedics

For reach the full potential of the county’s new firefighter paramedics required a change to state law that would allow emergency medical care by other than physicians and nurses. Supervisor Hahn recruited California Senator James Q. Wedworth (Hawthorne) and Assemblyman Larry Townsend (Lawndale) to introduce legislation that would authorize designated hospitals throughout the state “to conduct pilot program relating to mobile intensive care paramedics.” Powerful physician and nurse interest groups, however, immediately opposed the legislation. Nurses, for themselves, had not even long been allowed to administer medications or perform emergency medical procedures. Physicians and nurses felt that allowing paramedics to administer medications and medical equipment would “de-professionalize” their professions. The California Ambulance Association and California Bar Association also joined physician and nurse groups, expressing concern about how liability paramedics would be to malpractice claims. Governor Ronald Reagan indicated that he would veto the bill.

Supporters of the bill attempted to sway fellow legislators with restricting language that limited mandatory implementation of paramedic programs only to California counties with a population larger than six million. Since only Los Angeles County met this threshold, it was hoped that legislators from all other counties would not feel responsible for implementing paramedic programs in their own counties.

Supervisor Hahn, however, would hear none of it. He flew to Sacramento and personally met with the Governor Reagan to explain how the program would benefit heart attack victims and not limit emergency medical care to jurisdictional boundaries. This was personal to Reagan related personally because his own father had died after a heart attack when an ambulance crew declined to cross jurisdictional lines.

With new support from Reagan, California legislators passed the Wedworth-Townsend Paramedic Act of 1970 and the governor signed it into law on July 14, 1970.

Governor Reagan Signs Wedworth-Townsend Paramedic Act, 1970

Governor Ronald Reagan Signs Wedworth-Townsend Paramedic Act, 1970. Surrounding governor, left to right, is Assemblyman Larry Townsend, Sen. James Wedworth, and County Supervisor Kenneth Hahn. Photo from brochure for EMS 50th Anniversary Celebration.

The following month, under the direction of Dr. Graf, one of the nation’s first accredited training programs for firefighter paramedics was launched at Daniel Freeman Memorial Hospital.

Today, the successor to this program, the UCLA Paramedic Education Program at UCLA, is the largest paramedic school in the nation and considered one of the best.

Paramedics and Nurse Transport Patient in Field, Los Angeles County

Paramedics and nurse transport a patient in the field in Los Angeles County. Undated photo from brochure for EMS 50th Anniversary Celebration.

Emergency!

In 1971, television producers Robert Cinader and Jack Webb (Webb created the TV series Dragnet and later, with Cinader, created Adam-12), seeking ideas for a new TV series based upon firefighters, were introduced to Los Angeles County’s new firefighter paramedic program. Taking story ideas from real rescue accounts in fire station logbooks, the TV series Emergency! began to familiarize Americans with paramedic services. Cinader later served on Los Angeles County’s Emergency Medical Services Commission. After his death in 1982, Los Angeles County Fire Station 127 in Carson was dedicated in his name.

Cast of Emergency!, 1973

Cast of TV Series Emergency!, 1973. Photo by NBC via Wikimedia Commons.


Source: Los Angeles County Emergency Medical Services Agency and EMS 50th Anniversary Celebration.