Em. Med. Annual Report 2011 - Hennepin County Medical Center

Hitchcock nodded his approval. No papers were
signed. Ruiz became Chief of the ED. He
remained on the surgical staff and helped provide
surgical coverage for fifteen more years.
Ruiz found that he had much to learn if he was
going to be an emergency physician as well as a
general surgeon. One never knew what was going
to come through the door next. It was obvious that
residency training in EM was needed. Two second
year surgery residents, G. Patrick Lilja and Robert
S. Long (1938-2005) were drawn to the ED by its
variety and intensity. They had read an article in a
news magazine describing the new residency in
EM at Cincinnati General and called it to Ruiz's
attention. Within days Ruiz put together a
curriculum and sent it off to the fledgling ACEP for
a reaction. No response returned, but the
residency was started anyway in the fall of 1971
with Lilja and Long as the first residents. Hitchcock
allowed the two residents to switch to EM and
even agreed to continue their stipends for the
remainder of their year. The various services
welcomed the additional support from EM
residents. Hitchcock never told Ruiz he approved
of EM, but his support for the residency showed
his willingness to give it a chance.
In 1972, one of Ruiz's first goals was to stop the
practice of rushing critical patients "upstairs." A
well equipped room in the ED should be kept
ready for such patients. Prose was in complete
agreement, having observed the dangers of the
rush-upstairs practice as an ED nursing director.
An ENT exam room could be refurbished as a
"Stabilization Room." Prose successfully recruited
a respected Night Supervisor who was expert in
getting critical care initiated. Audrey Kuhne, RN
(1929-2005) joined the ED nursing staff in 1973
and helped the Stabilization Room effort obtain
hospital-wide credibility
and support. Ruiz and
Kuhne were successful
scavengers of equipment
and supplies from
throughout the hospital.
Some equipment was of
their own design and
G. Patrick Lilja, MD
made from scratch. The
Stabilization Room
contained the equipment necessary to resuscitate
almost any kind of emergency patient to the point
that he or she could be safely moved. Many
innovations were introduced there. For example,
cardiac ultrasound was first used there to
diagnose cardiac tamponade on presentation to
an ED. Not all cases could be "stabilized," but IVs
could be started, airways opened, x-rays and labs
obtained, and life-saving measures taken while an
operating room or intensive care area got ready.
To our knowledge, the Stabilization Room was the
first of its kind in the U.S. It can be stated that it
started a new age in emergency care.
Lilja and Long graduated from the EM residency
in 1972 and became EM staff. They almost
immediately began a first-of-its-kind program of
training pre-hospital personnel in emergency skills
on their own initiative. This included HCMC
ambulance "drivers," police, and firefighters. The
ambulance drivers became Emergency Medical
Technicians (EMT) and Paramedics according to
the skill level they achieved. ED nurses lamented
that Lilja and Long were not always in the ED, but
when patients arrived in better condition, they
appreciated their efforts.
In 1973, Ruiz was in the ED when a call came
from the airport reporting that an airliner was about
to land without its landing gear. The runway was
7:00 am