Frank's Legacy from a North American Perspective

I am highly honoured to describe the monumental North American legacy of Frank Pantridge. Most emphatically Frank became a great life-changer for many in Europe and the Americas. I thank Alun Evans for this opportunity to focus upon our extraordinary Pantridge endowment. Forty-three years ago one could not stand erect in a North American ambulance. Hearses, limousines and estate wagons transported the ill and injured. Undertakers had a conflict of interest. Little or no emergency care took place in these horizontal taxis. The driver sat at the steering wheel. The unattended patient rode strapped on a trolley in back. Frank Pantridge changed that. Feisty Frank revolutionised our emergency services in North America. He taught us to take care to the patient outside hospital. The Belfast system became the root and flower that crossed the Atlantic. It bloomed in and from North American casualty and emergency services. Frank made defibrillation and life saves from cardiac arrest a routine feature. He found autonomic distress a harbinger of sudden death in the acute coronary attack. He began treatment to thwart cardiac arrest and to save jeopardized heart muscle. He discovered that low energy electric shocks defibrillated. He introduced the miniature defibrillator that weighed only 3.2 kg. Frank influenced North American emergency services from rural village general medical practices to sophisticated urban systems. Our independent hospital emergency or casualty departments did not exist until Frank ignited our North American firestorm in out-of-hospital care. Bill Grace was Frank's first North American disciple. After he visited Belfast in 1968, Grace established mobile intensive care in New York City. Inspired by Frank and Bill, others followed suit. Five years after Frank began pre-hospital treatment of the acute coronary attack in Belfast, over 100 adaptations functioned in the USA and Canada. Ohio and Central Virginia developed local, regional, pan-urban and suburban pre-hospital cardiac care systems under the impetus of and many others. Like Frank we overcame apathy and opposition to modernisation by our local emergency services, by our hospital administrators and, sad to say, by our medical colleagues. Despite this we managed to systematise pre-hospital care based on the Pantridge example. Frank got us North Americans out of the ruts by pragmatic example linked to impeccable new exciting clinical data. We adapted his brilliant concept of critical care for people outside hospital. We trained personnel called paramedics. We deployed unique electrical and communications equipment first used by American …