The Miami Fire Department (MFD) established its rescue effort in 1939, with an initial function to administer first aid to firemen who were injured at the fire scene. In 1941, the first MFD rescue truck, designated as “Rescue One,” went in-service at the central station. It was basically a special extrication truck with advanced first aid capability which could also be dedicated to carry out the rescue of victims trapped in a fire as well as water rescue.
In 1964, Eugene (Gene) Nagel, MD a University of Miami physician and Assistant Professor of Anesthesiology, instructed Miami’s Rescue One personnel a novel resuscitation technique called “closed chest cardiac massage.” which had originally been invented in 1961. Dr. Nagle had became a fierce advocate of what would soon be known in the medical community as cardio-pulmonary resuscitation (CPR).
The following year, the Miami Fire Department became the first in the nation to establish radio contact between a rescue unit and a hospital using a radio transmitter,utilizing a special electronic modulator to convert the heart’s electrical signal into that of an audio tone. This tone was then transmitted over a radio frequency where a companion unit decoded the audio signal back into a recognizable EKG rhythm at the hospitals coronary care unit. At that time, the firemen could not legally administer any treatment beyond of that of first aid. However, these transmitted EKG’s vividly demonstrated that a number of patients died of cardiac arrest. It raised the belief that many of these patient’s could have been saved through the administration of an electrical cardiac shock technique that was now being called “defibrillation”.
From 1966 to 1967, Dr. Nagel, in conjunction with his colleague Dr. Jim Hirschman, refined the concept, creating the first pre-hospital domestic EKG telemetry unit in the U.S. in the garage of Nagle’s residence. Both assisted a small California electronics manufacturer, to develop a modulator that would contain effective shielding to prevent the interference that radio signals would produce during the conversion process of an electrocardiogram’s (EKG’s) milivolt (mv) into an audible tone that would be sufficient for recognizable radio transmission.
Photos courtesy Tom Watson and Charlie Perez
“Rescue 1” personnel started routinely transmitting EKGs to Jackson Memorial Hospital in March 1967. They used a Motorola “Dispatcher” commercial VHF radio base station, a lead acid battery and the demodulator, packaged in an actual “milk crate” and weighed 54 pounds. This configuration was soon repackaged in an aluminum case. The original defibrillator used included the 54 lb. Zenith/Travenol Defibrillator and the “Metro” which both had no EKG scope.
In 1968-69, Nagel, Jim Hirschman and other University of Miami Medical School colleagues conducted the first “paramedic” training at the University of Miami, which during its first year of implementation, was solely coronary care oriented. That same year, the Physio-Control Corporation introduced the “Life-Pak 33” defibrillator/scope which weighed 33 lbs and featured a 3” EKG scope for viewing. It also featured the capability to directly apply the defibrillator paddles to the patient’s chest and observe an instant EKG rhythm. It had been introduced at the 1968 Annual Conference of the American Heart Association at the Miami Convention Center .
The Miami Fire Department became the first fire department in the United States to successfully revive a lifeless patient in the field through defibrillation using a Life-Pak 33 in June 1969. The same year, the Florida legislature passed law 10-D-66 which served to legally permit pre-hospital emergency care in the State of Florida. In summary, the Miami Fire Department became the first fire-based paramedic program in America.
Keywords: paramedic, Miami, Life-Pak 33, Like-Pak, Lifepak, defibrillator, telemetry, Nagle, Hirschman, ambulance
Last Revision Date: 8/2/11 - 7:37 AM