Heritage: The Story of St. Mary's Hospital, 1880-1980
By Leo G. Bryne and Sister Alberta Cammack, C.S.J
Chapter II Modern Medical Complex
In 1965, the Emergency Room was comprised of five stretchers and three wooden tables in a total of four rooms. Entrance from the outside was through a set of double doors which led from a loading dock with ramps on either end. The ambulance backed in so that the stretcher with the patient could be carried out onto the dock.
As recently as the sixties, the ambulance companies were by mortuaries. To be an ambulance attendant, a person took a few hours of first aid training. Pre-hospital care in emergency vehicles was nonexistent.
St. Mary's, at that time, with its teaching program, had the Emergency Room covered by interns and residents with a physician on call.
Besides a trauma room and a larger orthopedic room, there were two examining rooms, eight by ten feet, each containing a bed, sink, chair and wooden cupboard. These small rooms became crowded in an emergency situation which called for an intern, a resident and two nurses.
The Recovery Room gave oscilloscope and defibrillation capabilities to the Emergency Department. Intravenous therapy was begun by the nurse. It was a staff nurse's duty to send for the doctor and immediately prepare the patient for examination and treatment. In real emergencies, the nurse proceeded to stop bleeding, cleanse the wounds and calm the patient. The intern was on call to help until the person's physician or the physician on call arrived.
New emergency facilities, opened in the North Wing in 1971, included three large surgical suites, each able to accommodate five patients. Wheeled stretchers, with removable beds, allowed the patient to be transported to the nursing floors without having to transfer from stretcher to hospital bed.
On July 1, 1971, Emergency Room Associates, a group of doctors skilled in emergency medicine, took residence at St. Mary's; however, on May 1, 1973, due to reorganization and personnel changes, Pima Emergency Physicians replaced this first group. "P.E.P.," as it is called, has continued to staff the Emergency Room on a 24-hour basis.
In 1973, in an effort to improve ambulance patient care, nurses from the Emergency Room began to function as part of the ambulance crews in evaluating the immediate needs of the victims of accidents and trauma. This was a nine-month pilot project made possible through a $15,000 grant under the Arizona Emergency Service Act administered by the Department of Public Safety. In communication with the hospital through a central radio system, the nurse was able to describe the patient's condition and to dispense medication or start intravenous treatment upon orders of the doctors. Each nurse had extensive experience in the Emergency Room and had recently completed an Emergency Medical Technicians' course.
The presence of a nurse in the ambulance proved so beneficial that it gave rise to the Paramedic Training Program. It was the first of its kind in Arizona with the training being provided jointly by Pima Community College and St. Mary's to skilled, at-the-scene emergency care to victims of heart attacks and other life-threatening emergencies. The curriculum was taught by the emergency doctors of St. Mary's. In the fall of 1974, fourteen Paramedics graduated in the first class, accepting certificates and plaques in recognition of their intense study and work, which combined classroom lectures with clinical experience, along with actually treating patients in the ambulance. Private sector individuals, firemen and highway patrolmen were included in this program.
The extension of emergency ambulance services evidences in the Paramedic program is now paralleled by helicopter emergency services. St. Mary's Helipad was constructed in 1974, and within two years received victims of a boiler explosion from Douglas, a man who had suffered burns while fighting a forest fire, and a hiker who had fallen and was injured while climbing in the mountains. Presently, a motorized golf cart with room for a stretcher transports the patient from the Helipad to the Emergency Room. The Helicopter Emergency Service is operated by the Department of Public Safety. Each unit has a Paramedic with a Paramedic Medical-Technician as pilot. Telemetry between hospital and ambulance, established in 1975, gave the capability to send EKG information.
The Pima Emergency Physicians have a low rate of personnel turnover, and new faces that appear are due to the expansion of the group. There is always a physician on duty working an eight-hour shift. An extra physician is on call should he be needed. The emergency doctors also respond to in-hospital emergency calls, including cardiac arrests. They also examine patients at the request of the Medical Staff.
In the Emergency Department, no one person can claim credit for its accomplishments, as excellent care can be achieved only by cooperative efforts. There are twenty-one on the nursing staff including seventeen Registered Nurses. In a crisis situation, each member of the team is called to peak performance, and there is a sense of high regard for each one's abilities. There are two Admitting Clerks and one Ward Clerk in the department. Computers are used for admitting patients and for ordering examinations.
Along with its crisis care, the Emergency Room functions as an approved Poison Control Center for Tucson, giving information and treatment to those who ask for help.
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