1970: Metro Ambulance Service MCCU

Cross Posted: 1966 to 1986 History Equipment Buses, Ambo's, & Rigs
Submitter/Author:Richard Steinberg, MD/Jane Carter, RN
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1970: Metro Ambulance Service MCCU

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Metro Ambulance Service, Inc. Mobile Coronary Care Unit (MCCU)

In 1970, Metro Ambulance Service operated this Mobile Coronary Care Unit which was custom built by the Miller/Meteor (M&M) Corporation in Piqua, Ohio on a late 60's Cortez RV chassis. This unit was equipped with a portable Zenith Defibrillator, a Tektronik Lead II cardiac monitor and a Cambridge 12-lead EKG printout. The drug kit contained 1:10,000 Epinephrine, Atropine, Lidocaine, Sodium Bicarbonate, Calcium Chloride and Talwin. Intra-venous (IV) fluids consisted of Ringers Lactate, Dextrose 5% in Water and Normal Saline. The vehicle featured a John Walker bio-telemetry unit which converted EKG electrical signals to sound waves and transmitted the signals over a Motorola MOTRAC low-band VHF radio to the coronary care unit at Kennestone Hospital in Marietta, Georgia (an immediate Northwest suburb of Atlanta). Here a John Walker companion unit decoded the sound waves back into electrical signals which were then read on a scope. Metro used low-band VHF radio to transmit EKG telemetry to Kennestone years before UHF MED-Channel hospital communications became available in the Metropolitan Atlanta Area in 1976.

Metro Ambulance Service, Inc. had became one of the first several EMS services to institute a Mobile Coronary Care Unit (MCCU) in America, immediately following the Saint Vincent's Hospital MCCU Project in Manhattan, NYC in the Winter of 1968. In the Summer of 1968, Metro had installed a Zenith Defibrillator, a 12-lead Cambridge EKG printout and a John Walker EKG signal modulator/demodulator in a 1968 Chevrolet 54" raised roof "Suburban" ambulance manufactured by the Miller-Meteor Corporation. The drug/IV kit contained 1:10,000 Epinephrine, Atropine, Lidocaine, Sodium Bicarbonate, Calcium Chloride and Talwin. Intra-venous (IV) fluids consisted of Ringers Lactate, Dextrose 5% in Water and Normal Saline. The vehicle featured a John Walker bio-telemetry unit which converted EKG electrical signals to sound waves and transmitted the signals over a conventional rotary dial telephone from a patient bedside to the coronary care unit at Kennestone Hospital in Marietta, Georgia. A core group of Metro Ambulance Service medics had been previously selected to under go a specialized 56 hour Coronary Care Unit (CCU) course at Kennestone Hospital in Marietta, Georgia. The selected group was returning Vietnam War medics who had also completed American Red Cross Basic and Advanced First Aid, the newly introduced American Heart Association CPR course for CCU nurses and the three-day Emergency Care Practical Course sponsored by the American Academy of Orthopedic Surgeon (AAOS). Formal state EMT training would not be offered until the fall of 1971 and formal Cardiac Technician and Advanced EMT (Paramedic) training would not be formally legislated until 1976.

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In this 1968 photo, Dr. Luther Fortson, medical director for both the  Kennestone Hospital's brand new CCU and Metro Ambulance Service's Mobile Coronary Care Unit, is shown receiving a telemetry strip from the Metro Ambulance MCCU medics at a patient's bedside and directing medical intervention. Jane Carter, RN was the head of the Kennestone Coronary Care Unit (CCU) at Kennestone Hospital and coordinated the training of both CCU nurses and Metro Ambulance medics under the medical direction of Dr. Fortner. She had been sent by Kennestone Hospital to Methodist Hospital in Houston to study under Dr. Michael DeBakey, the legendary open-heart surgeon of that era. To legally authorize Metro medics to receive CCU training and carry out advanced life support procedures, Dr. Fortson wrote Georgia's then Attorney General Arthur Bolton. He requested a legal opinion from the Attorney General as to the legality of Metro Ambulance Service medics administering such procedures in the field in an era where no formal legislation existed. Such an opinion was also requested for the legality of nurses administering these same procedures at Kennestone Hospitals new Coronary care Unit (CCU) which was one of the first in the Nation to open in 1968. In that era, nurses were prohibited from administering ALS procedures which could only be administered by a Georgia licensed physician. Attorney General Bolton responded with the opinion that "whatever is accepted in your community by the medical profession" was acceptable and would not violate Georgia's Medical Practice Act. This historic opinion thus allowed both CCU nurses and Metro's MCCU medics to administer ALS procedures and medications under the oversight and supervision of Dr. Fortson and pursuant to his active medical Board license. Metro was viewed as "an extension of Kennestone Hospital's CCU."

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External Resource Link: 1968: Luther Fortson, MD
Keywords
: Luther Fortson, MD, metro ambulance, atlanta, marietta, MCCU, paramedics, ALS, ambulance, Life-Pak 33, Bo Pounds

posted: 7/19/ 08 - 3:55 AM