An education is built over time, assignment by assignment, lecture by lecture, course by course, semester by semester. Between registration and graduation, every day of a student’s education is a building block, a pivotal piece of their degree. One Class, New Knowledge is a series of stories that captures the learning that happens on a single day in a single Polk State classroom.
For Polk State Emergency Medical Services students, life after graduation is a blurred rush of 24-hour shifts.
There are sirens and IV’s, chest compressions and the constantly ticking clock.
Seconds are crucial when saving lives, leaving no time to contemplate the EMS profession. How it came to be and why, the challenges its early pioneers faced and overcame, how it has evolved and improved — those are the kinds of topics that working EMTs and paramedics don’t get to explore once they’re on the job.
Which is why Polk State EMS recently carved aside a special day, allowing EMT and paramedic students the time to learn about the field from one who helped to shape it.
“We have a chapter that we cover in our textbooks called ‘History of EMS,’” said Frank Dunn, coordinator of clinical education for the EMS program.
“We talk about this happened on this date, that happened on that date. But having someone come in, who was actually there and actually helped create the EMS profession, it puts what our students are about to do with their lives into a totally different perspective.”
In late April, the EMS program hosted Dr. Eugene Nagel — an anesthesiologist who also came to be known as the “father of EMS” — for a guest lecture.
Nagel served as medical director for the City of Miami Fire Department’s Rescue Division from 1963 to 1974. A variety of Internet bios describe Nagel’s accomplishments during that time.
He trained firemen in basic emergency treatments and what was then referred to as “closed chest cardiac massage” — later known as CPR.
Under his direction, the department was the first to use radio communication between hospital-based doctors and fire department rescue units responding to emergency calls.
The department was one earliest adopters of mobile EKG technology, allowing first responders to collect potentially life-saving data and transmit it to hospital-based physicians.
In 1969, City of Miami Fire Department paramedics, using mobile EKG technology and radio communication with hospital-based physicians, became the first to successfully defibrillate — or “shock” — a patient back to life.
Nagel’s work led to legislative changes both on a statewide and national level, paving the way for the modern EMS system.
During his April 23rd lecture at Polk State Winter Haven, Nagel recounted these milestones — and all the moments in between that inspired him.
In the early days of EMS, ambulances doubled as hearses, Nagel said, because a person who suffered a heart attack outside the hospital had near-even odds of dying and living.
“If you didn’t save a life, it was a very convenient way of getting the body to the mortuary,” said Nagel, 90, who now lives in Winter Haven.
In the early days of emergency medicine, doctors rode in ambulances, an inefficiency given that a lot of calls were for minor injuries or were false alarms.
There had to be a way to give victims of heart attack — and illnesses and injuries of all kinds — a better chance of survival without wasting doctors’ precious time.
“We had to connect the firemen in the field with the hospital, so they could talk back and forth about the patient without having to wait for the patient to be transported,” Nagel said of the developing radio telemetry for rescue vehicles.
“Once we did that, we could start saving lives.”
A telemetry unit for an ambulance, Nagel added, once weighed 35 pounds.
“Now they’re only three or four,” he said.
The difference EMS could make for patients was immediately apparent to Nagel, even when the field was in its infancy, he said. He recounted a patient who was an alcoholic, but stopped drinking after being saved by a paramedic.
“He felt so grateful,” Nagel said.
During his career, he said, the City of Miami Fire Department made it a regular practice to reunite the paramedics with the patients they’d saved, so that each could reflect on the fateful moments they had shared.
Aside from the gratitude of patients, another enduring theme of his work was the general attitude that paramedics were incapable of learning and carrying out more advanced medical procedures, such as starting an IV.
Nagel believed in his paramedics and their potential, so much so that he went before the Miami City Commission in the late 1960s and had a paramedic start an IV drip in his arm. The commissioners, seeing firsthand that a first responder could carry out the procedure, granted the city’s paramedics the permission to start IVs.
Nagel took a similarly impassioned tact to win paramedics the ability to intubate patients.
In the mid-1970s, a TV show called Emergency! hit the airwaves, and the profession changed forever.
“That was the biggest boost for emergency care and EMS,” Nagel said. “Suddenly cities across the country wanted paramedics. It created an appetite for EMS in this country like nothing else.”
Nagel left the two-dozen or so Polk State students with reminder of what will be required in their new profession — beyond the ability to give CPR, start an IV, or work a defibrillator.
“There are car wrecks and gunshot wounds, and poisonings and falls, and a myriad of other medial disasters that you all are expected to deal with,” Nagel said. “It takes a lot of dedication to get up at 3 a.m., or in the rain, and try to take care of someone who’s lying on the side of the street.”
Among the students who attended Nagel’s lecture was Jivinson “Jive” St. Juste, a Lakeland resident studying to be a paramedic.
Nagel appears in the first pages of the paramedic textbook, St. Juste said, but hearing him speak was an experience that brought the material to life.
“He was so willing to answer our questions, and he shared his knowledge so openly,” said Jivinson.
“He made me see how far EMS has come.”
The field of EMS has three tiers, with paramedics at the top, above emergency medical technicians and emergency medical responders. Polk State EMS offers training options for those seeking to work at any level of the EMS ladder, and an associate’s degree in EMS for paramedics interested in career advancement. In addition to EMS, Polk State Public Safety offers associate’s and bachelor’s degrees in Criminal Justice, and an associate’s degree in Fire Science. In addition to EMS, Polk State Health Sciences programs include Cardiovascular Technology, Diagnostic Medical Sonography, Nursing, Occupational Therapy Assistant, Physical Therapist Assistant, Radiography and Respiratory Care.