The Columbus Division of Fire (CFD) was one of the first fire departments in the country to offer emergency medical services. In 1931, a Lyons Pulmotor, an early respirator device, was donated to then Fire Chief Edward Welch to help resuscitate firefighters.
Only a few years later in 1934, that device was mounted to the back of one of the division’s new motorized vehicles, officially creating Columbus’ first emergency medical squad.
A few decades later, the CFD would be on the forefront of emergency medicine again by partnering with Ohio State University to create the country’s first mobile coronary care unit vehicle.
A listener wrote to WOSU’s Curious Cbus to learn more about the “Heartmobile” program, and Columbus’ first paramedics.
Creating the Heartmobile
In the early 1960s, Coronary Care Units started popping up around the country. Ohio State University created its Coronary Care Unit in 1964. The unit’s main goal was to reduce mortality rates of those having myocardial infarctions, known more commonly as heart attacks.
However, doctors quickly noticed a problem with waiting for patients to make the journey to the hospital. Dr. James Warren, OSU’s director of medicine, was one of them.
“The trouble is that over 60% of the people with heart attacks never live to reach the hospital,” Warren said in a 1972 documentary by the National Committee on Early Coronary Care titled “A Life on the Line.” “If we could reduce their mortality rate by the same amount that we can in the hospital, we could probably save over 100,000 lives per year in the USA.”
In 1967, Dr. Frank Pantridge of Belfast, Northern Ireland, came up with a solution to this, bringing the coronary care unit to the patient.
Dr. Warren saw Dr. Pantridge’s success with his mobile coronary care unit, and started work to create a similar program in Columbus. He first recruited Dr. Richard Lewis, who was working at Stanford. Lewis was eager to join the program, and in turn recruited Fred Davis.
Davis was also working at Stanford at the time, in the catheterization laboratory, or “Cath Lab,” but was convinced by Lewis to join the team in Columbus.
“I was hired as the technical director for the division of cardiology for the cath labs,” Davis said. “Because of my technical background I'd had in the service, that's kind of how I got into it with Dr. Lewis. And kind of went from there.”
Davis was one of several to help design the Heartmobile. He said the university worked with Dave Ellies Industrial Design, which was located on Kinnear Road.
“We went over there and basically out of cardboard set up this mock room, which ultimately was the dimensions of the Heartmobile itself,” Davis said. “That kind of gave us an illustration of what we could put in there and what worked and what didn't work. From that, we started collecting material.”
The largest issue the team faced in the design process was the weight of the equipment that needed to be on board. The vehicle had to move fast, and a heavier vehicle is harder to navigate.
“Unfortunately, the defibrillator alone was quite heavy,” Davis explained. “It was probably around 35 to 40 pounds, so it was enough to where only one guy could carry it.”
Davis also said powering the equipment was another concern. The portable electrocardiogram (ECG) on board took eight D-cell batteries. Balancing how to power equipment with eliminating extra weight was a months-long process.
However, the design team did figure it out, and in 1969 the Heartmobile sprang into action.
The nation’s first Mobile Coronary Care Unit vehicle
Custom-built on a 1968 Clark Cortez motor home chassis, the 20-foot-long van carried an electrocardiogram, two defibrillators, one portable and one built-in, an oxygen supply and a case of emergency medicines. The Heartmobile was gold and white, chosen by the design firm to be “soothing” to patients.
The van was stationed outside of Means Hall, the university’s former tuberculosis hospital, which was demolished in 2009, in a small detached garage affectionately named the “Heart Shack.” That garage is also where most of the training for the firefighters took place.
“Usually three off-duty firefighters, who were in training at the time, would ride in the vehicle along with a physician that would come out of hospital, which is crazy to think of,” said Julie Goodwin, executive director of the Central Ohio Fire Museum.
Physicians would be on week-long rotations for the Heartmobile, often reporting from the coronary care unit, which was located on the sixth floor of Means Hall, or the intensive care unit, which was on the eleventh floor of the main hospital.
The 1972 documentary also showed technicians in communication with the hospital during runs. They were able to send a copy of the ECG readings to the hospital in real time, with both machines printing out the readings. In the documentary, you can hear Lewis in the hospital and a paramedic in the field discussing ECG readings in real time and Lewis recommending treatment.
The first seven months of the Heartmobile program were a resounding success. In the 1970 research paper the team published, the vehicle responded 500 times to coronary calls, and was often able to make it to the scene within 15 minutes. The paper also included statistics regarding 160 additional calls, where two people were successfully resuscitated after appearing dead.
The documentary also interviews a Columbus resident, John William O’Brien. O’Brien had suffered a heart attack himself, and his wife called the fire department, which sent the Heartmobile. During the documentary, the Heartmobile responds to a call for O’Brien’s friend, Clarence Morris, who also suffered a heart attack.
“If I was fortunate enough to have been a millionaire at that time, I would have laid it on the line for the job they'd done for me and for my buddy Clarence Morris tonight,” O’Brien said.
The Heartmobile was officially incorporated into the Columbus Division of Fire in 1971. Around this time, the physicians in the program concluded that the trained firefighters were fully capable of responding to calls without a doctor present. A follow-up paper in 1972 also added that including physicians on calls made the program much more expensive.
With those two things in mind, the Heartmobile ditched the doctors, and Columbus’ first paramedics took over. The first paramedics in the country were located in Pittsburgh at Freedom House Ambulance Service, founded in 1967.
However, accredited programs training paramedics wouldn’t exist until years later. In fact, there wasn’t any standardized training for emergency medical personnel outside of a hospital. So the Ohio State medical program created one.
Dr. Stephen Schaal was the director of the Coronary Care Unit at the Ohio State University Hospital starting in 1971. He said he was one of the people who helped create the training curriculum for Columbus paramedics, and often volunteered to train firefighters as paramedics in the Heart Shack.
“I was the one teaching electrocardiography at Ohio State to the cardiologists and residents,” Schaal said. “It was elective initially, that the firemen who had an interest in doing that kind of work would sign up to be trained to be part of the original team.”
Schaal also credited nurse Katie Sampson, who was the assistant director of the Heartmobile training program, with helping to create and run the training of paramedics. Sampson is featured in the 1972 documentary, explaining how the training program worked.
“The training we put the men through is the same basic course that we give the nurses that work in the coronary care unit,” she said. “When these men come to us, they already have training in general medical emergencies and victim care.”
After the Heartmobile
The vehicle was officially retired from being the Heartmobile in 1972. Columbus Fire replaced the vehicle with four new Horton ambulances, which were made in Grove City.
The new ambulances fixed an issue Davis identified with the original vehicle: it was too big for some historic Columbus streets.
“It was huge, and that was one of the fallbacks of the Clark Cortez, was that we'd get down into German Village and you couldn't turn around,” Davis said. “You'd have to back out of places.”
As for the original vehicle, it wasn’t done serving the CFD. All of the medical equipment was stripped from the vehicle, being kept by Davis, Sampson, and others who worked on it as souvenirs. Some also kept equipment for historical reasons, like the first CFD historian and Central Ohio Fire Museum founder Lt. Robert Throckmorton.
In 1973, the van was repainted and used as an Honor Guard transport vehicle for Columbus Fire. Two years later, it became a mobile recruiting van. In 1980, the city determined the vehicle had become too expensive to maintain, and it was put in a surplus lot and was going to be auctioned off.
However, that’s not what ended up happening. A few weeks before the auction was set, Throckmorton received an anonymous phone call about the Heartmobile.
“There is a gate unlocked, there are keys under the mat. If you want to come get it, get it,” Goodwin said is what Throckmorton was told.
As Throckmorton has told it, two firefighters from Station 2 downtown went over to the surplus yard, and like the call said, walked through an unlocked gate to the Heartmobile. They needed the night mechanic to help jump-start the old van. As described by the Central Ohio Fire Museum’s page for the Heartmobile, the van was then “rescued” from the salvage yard.
The van was moved from station to station over the next several years, never fully hidden, just stored “somewhere else.” The city did eventually officially give the van to the Central Ohio Fire Museum.
In 2005, the museum started work on restoring the vehicle. It was led by the museum’s co-founder Bill Hall, who was among several people who donated their time to restore the vehicle. The restoration was extensive. The vehicle was stripped down to its chassis and painstakingly rebuilt. A majority of the equipment on board is original, donated to the museum by those who saved it. The process took more than 9 years and $135,000 to complete.
Today, the fully restored vehicle sits in the machinist shop behind the Central Ohio Fire Museum and is available to visit on the museum's 2:15 p.m. tour time. Davis has seen the restored vehicle and says the museum has done a fantastic job.
A Lasting Legacy
Heart disease is still the leading cause of death in the United States, but emergency medical intervention has undoubtedly lowered mortality rates. The American Heart Association estimates EMS responds to more than 250,000 people having an out-of-hospital heart attack each year.
There are no specific mobile coronary care vehicles anymore. The technology on the Heartmobile has decreased in size and price, allowing every ambulance to be a mobile coronary care unit.
Dr. Raymond Magorian is a cardiologist for OSU and worked under Dr. Warren. While Dr. Magorian didn’t work on the Heartmobile program, he’s been able to see its lasting impact.
“What it did was provide the potential to correct a lethal heart rhythm prior to the patient arriving in the emergency department, prior than getting into from the emergency department up to the coronary intensive care unit by having a monitor in a mobile van,” Dr. Magorian said.
As for why Columbus was home to such an innovative program, Dr. Magorian had an easy answer.
“The reason it happened in Columbus is you had J.B. Warren in Columbus and you had very supportive people around him,” he said.
Davis and Schaal had similar fond comments about the program.
“It was a hoot. I mean, all the guys from the firefighters to Katie Sampson, to Jim Warren, to all of these people,” Davis said. “There were a lot of people, a lot of workers, but every one of them were just high class people that loved the program.”
