California Mobile Heart Units
California firemen trained and licensed as paramedics may now administer advanced medical treatment, including defibrillation and injections, under the Wedworth-Townsend paramedic law recently enacted by the State Legislature.
Los Angeles County, Los Angeles City and Inglewood Fire Departments are now operating rescue units with trained paramedics.
Los Angeles County began operations late last year with Rescue Squad 59 operating out of Harbor General Hospital Station 59. This first heart care unit operated by a fire department in the western United States was authorized by County Supervisor Kenneth Hahan and Chief Richard Houts.
The unit, manned by two firemenparamedics and a registered nurse, operated up to 5 miles from the hospital—a limitation imposed by high frequency radio equipment that telemetered information from the patient to physicians doing the monitoring at Harbor General Hospital. Nearby Rescue Squad 36 also responded.
Heart data telemetered
On arrival, the firemen immediately placed small metal leads on the patient and telemetered his vital heart information to a doctor in the hospital’s heart unit. The M.D. radioed information back to the scene—defibrillate, start closed chest massage, administer certain drugs, increase oxygen, etc.
The portable defibrillator carried on the unit delivers an electrical charge designed to restore a normal heart beat to a patient whose heart is in irregular rhythm. The firemen monitor the EKG on an oscilloscope as it is taken. Basic “tools” carried on the county unit are stethoscope, EKG monitor, oscilloscope and ventilatory assistance equipment.
Houts originally assigned six firemen, all of whom had rescue squad experience, to training at Harbor General 10 weeks before the first shift was activated. Assigned in pairs, the fire fighters went with doctors on their daily patient visits. The firemen checked vital signs, took blood pressures, read electrocardiograms and performed as student medical assistants.
Afternoons were spent in the classroom, where medical doctors qualified the six fire fighters and a score of registered nurses to become cardiac care unit specialists.
“We are gratified that our firemen scored extremely high in the final testing,” said Houts. “It was necessary for them to learn a vocabulary of 200 medical terms and to recognize certain cardiac malfunctions.”
UCLA evaluating program
The entire program is being evaluated by UCLA for possible expansion to other areas as part of the university’s study on emergency medical services. The state’s Medi-Cal Program paid for specialized equipment.
After the new legislation took effect, Los Angeles County modified its procedures because of the additional personnel and the fact that the R.N. was no longer mandatory on the unit. Rescue Squad 36 now covers the basic response area with 59 as a backup.
(Squad 59 was used as a field medical unit during the Malibu fire disaster in late September. The paramedic-firemen washed out inflamed eyes and performed other valuable field first aid.)
Six Los Angeles City firemen are manning Rescue Ambulance 53 in San Pedro. RA 53 has telemetering equipment and the city paramedic-firemen communicate with physicians at Harbor General Hospital.
“This is one of the most significant advances in life saving techniques in the City of Los Angeles, comments City Chief Raymond M. Hill. “This unit has been designed to reduce one of the most dangerous elements in heart attacks—time. It brings the hospital closer to the patient.”
Hill noted that in approximately six months, a study will be made of the unit to determine its effectiveness and the possibilities of expanding the service throughout the city.
Firemen licensed as paramedics man the Inglewood City rescue unit and L.A. County Rescue Squad 18 in the Lennox area, near Inglewood. Using a slightly different system than County 59 and City 53, these units respond with paramedic-firemen, but telemetering is done through L.A. County Heart Association mobile vans stationed at Centinella Valley and Daniel Freeman Hospitals.
The new L.A. City, County and Inglewood paramedic-firemen were also trained at Harbor General Hospital and have well over 200 hours of study. They have studied under the direction of Dr. Michael Criley and Dr. James Lewis.