Los Angeles County Emergency Paramedics History
History of the Dr. J. Michael Criley Paramedic Training Institute
In 1969, two paramedic education programs were initiated almost simultaneously in Los Angeles, the County Paramedic Training Institute (PTI) at Harbor General, under the direction of Dr. J. Michael Criley and the Daniel Freeman Hospital program, directed by Dr. Walter Graf. The two programs differed in configuration and model of service delivery. Dr. Criley felt that the emergency medical system should utilize existing personnel, vehicle and dispatch systems and based his program on Dr. Eugene Nagel’s model and success with firefighters in Florida.
Dr. Criley, as head of the Cardiology Division at Harbor General Hospital was interested in the treatment of patients suffering “heart attacks” and the positive results from early treatment in the field. As a visionary, he advocated the use of defibrillators in the field and public buildings. This interest led him to the development of a new pilot program to train firefighters to deliver cardiac care in the prehospital setting.
The first PTI graduating class was composed of six Los Angeles County Fire Department firefighters, trained at Harbor General Hospital under the direction of Dr. Criley and Coronary Care Unit Nurse, Carol Bebout. The focus was on the care of the cardiac patient. The course spanned 192 hours of classroom time and emergency department experience.
Following the first class, it became apparent that the training curriculum needed to be expanded to include a variety of emergency medical care incidents. The course curriculum was expanded to 325 hours and a “buddy system” was initiated, requiring ride-along experience and approval by preceptors before assuming full, independent duties.
By 1972, the number of hours required for certification was increased to 1000. Because of the demand for training and funding from federal grants the County PTI opened a second school at LAC+USC. Five to six classes per year were trained at each facility, with class size of up to twenty-five students.
In 1974, Dr. Ron Stewart, a bright, energetic, physician became the Director of the Paramedic Training Institute. Dr. Stewart, originally from Canada, completed his residency program in Emergency Medicine at the University of Southern California (USC) and worked in LAC+USC emergency department. As the program administrator, with his specialty being emergency medical, Dr. Stewart had a profound and lasting impact on paramedic training. One of Dr. Stewart’s first objectives was to modify the training curriculum and materials at hand. The course of study, up until this time, consisted of texts borrowed from nursing, physician, and army corps education.
Dr. Stewart undertook the enormous task two year task of writing the comprehensive, four volume set, the “bible” of paramedic instruction. This new curriculum focused on specific field care using pictures, terminology and examples that were suitable to the firefighters background. This four volume set has been used as the basis for core curriculum in paramedic programs nationwide. Volume I of the “Red Book” is still in use at PTI today.
Dr. Stewart describes the “evangelical zeal” with which he approached this task, recalling the eighteen and twenty hour days he commonly put in while trying to fulfill his normal physician duties as well as revise the paramedic course of study.
In 1995, PTI affiliated with the El Camino Community College District. This affiliation allowed PTI to enhance its standing as an academic program, provide 32 college units to each graduate, accept private students sponsored by El Camino College, decrease the price of tuition and offset program costs. Drs. Criley and Stewart established PTI, providing a strong foundation to an enduring program. Through the years changes have been made to the program to meet the needs of the community, changes in regulations and medical care based on research.
Medical Directors, that have followed the footsteps of the Dr. Criley and Stewart and worked to enhanced the paramedic program and PTI include:
- Dr. Ron Crowell
- Dr. William Koenig
- Dr. Frank Pratt
- Dr. Samuel Stratton
- Dr. John Celentano
- Dr. Marianne Gaushe-Hill
- Dr. Dave Persse
- Dr. Lee Nelson
- Dr. Cesar Aristeiguieta
- Dr. Scott Younquist
Along with the Medial Directors there have been many dedicated administrators and educators that have been committed to ensuring that the individual paramedic graduate has the knowledge and skills to care of each patient they encounter in a safe and competent manner.