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physicians who would go to patient ’ s homes and evaluate them and rush them to a hospital . 3 Similar to many other hospitals nationwide , the “ emergency room ” at Louisville General Hospital was staffed by interns and extremely experienced nursing staff who practiced in a crowded and cramped space .
Dr . Donald Malvern Thomas , chair of the Department of Anesthesiology at UofL at this time , was quick to recognize the need for change in emergency medical care . Dr . Thomas witnessed changes occurring in other parts of the country and strove to bring that change to Louisville . He had recently resigned after an argument with a consultant about patient care during surgery . He was then offered the position of the director of the emergency department by Dean Douglas Haynes . He became the first chair of the emergency department in 1970 . Initially Dr . Thomas anticipated this appointment would be a stepping-stone to another anesthesiology position . Instead , he spent the next 21 years shaping emergency medicine in Louisville and nationwide .
Prior to his appointment as chair , emergency department visits had quadrupled between 1955 and 1970 to 85,000 visits per year . 4 “ Emergesic ,” a simple aspirin dyed half blue and half red , was dispensed liberally as a powerful pain medication . 7 This approach changed when he took charge . He was a founding member of the American College of Emergency Physicians ( ACEP ) and in 1971 joined the burgeoning emergency medicine movement . The first academic emergency department had been established months earlier by Dr . Gail Anderson at the University of Southern California . As a condition of his appointment , Dr . Thomas insisted that emergency medicine become a full academic department in 1971 . 4
Dr . Thomas ’ prior experiences were fundamental to the vision he brought to the emergency department . While practicing as an anesthesiologist , Dr . Thomas was integral in the creation of the first ICU in Louisville , which was a 24 / 7 OR suite and recovery room at Louisville General Hospital . 8 Prior to his appointment , he became the fire surgeon for Louisville Fire Department in 1966 . With this appointment , he was heavily involved in establishing CPR as routine practice for all first responders in Louisville . His involvement with the police , firefighters and EMS crews created a man with a deep appreciation for the “ blue collar ” individuals that provided much of the pre-hospital medicine . 7 He would quip that , “ They are the only ones who truly put their butts on the line .” This mutual respect was foundational to the development of the Department of Emergency Medicine and subsequent residency program .
Dr . Thomas always placed a premium on efficiency , irreverently termed “ moving the meat .” While other emergency medicine programs became increasingly focused on the white coat and bearing the deep-rooted “ white collar ” nature of being a physician , Louisville earned a “ blue collar ” reputation from Dr . Thomas ’ leadership style . Casual attire , including running shoes , was regarded as acceptable attire for residents who often mirrored Dr . Thomas ’ own unique wardrobe . 7 Dr . Thomas ( aka the “ Chief ”) was often described as a “ fiery red-haired man ” equipped with a firearm , police dispatch radio , handcuffs and a fire helmet . 5 Frivolities and traditional hierarchal structure were exchanged for effective and efficient patient care , especially in Room 9 . This is where lives were changed , saved or lost .
When Dr . Thomas assumed responsibility for the Louisville General Hospital ED in 1970 , he promptly established a residency program with Dr . Jim Bacon serving as the first resident . At its inception , Louisville became the fourth emergency medicine residency program in the country . To date , the program has graduated 450 residents .
After establishing the residency program , Dr . Thomas styled “ Room 9 ” as the resuscitation space in the ED in 1971 . At the original Louisville General Hospital , the entrance to the emergency department was via a hallway . On the right side of the hallway there were various offices and specialized treatment rooms , numbered one to five . At the triage desk , to the right there was a curtained area for only female patients . On the left , an identical area was created for all the male patients . Traversing back out the hallway , Room 9 was at the end by the entrance . By design it was a large room equipped with two beds present that could flex to fit three as necessary . This design was among the first emergency department resuscitation bays in the U . S . When University of Louisville Hospital was built in 1979 , the Room 9 moniker stuck with the new resuscitation bay .
Prior to the establishment of Louisville ’ s Room 9 , the sickest patients were often whisked directly to the OR despite the uncertainty of their needs . There were no level 1 traumas . Subsequently , urgent negotiations and discussions among emergency medicine , trauma surgery , neurosurgery , orthopedic surgery and other surgical sub-specialties created a novel algorithm of traumatic injuries . In the 1970s , Louisville ’ s Department of Surgery Chair , Dr . Hiram Polk , and Dr . Donald Thomas , Chair of the Department of Emergency Medicine , collaborated to train emergency medicine and trauma surgery residents with supervised autonomy . Subsequently , the late Dr . J David Richardson , for whom our trauma center is named , contributed mightily . Two service directors , Dr . Royce Coleman from the ED , and Dr . Brian Harbrecht from the trauma service , continuously assured great trauma care for decades .
While Dr . Thomas conceived the design of Room 9 resuscitation , it was further refined by Dr . Dan Danzl , who became the second chair of the Emergency Department in 1991 . Dr . Danzl brought the credibility of academic excellence with his positions as a founding board member of the editorial board for the Journal of Emergency Medicine , president of the American Board of Emergency Medicine and chair of the Accreditation Council for Graduate Medical Education ’ s Residency Review Committee for Emergency Medicine . 6
For nearly 30 years as chair , Dr . Danzl advanced the UofL program ’ s traditions and developed academic rigor that persists to this day . He states that his goal was to create residents that he would feel comfortable sending his family or any in the community to for care
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