First logo of the ambulance service

FROM THE AMBULANCE SERVICE

EMERGENCY: ìPLAN CARACASî
TO THE MEDICAL EMERGENCY SERVICE
CB PRE-HOSPITALITY METROPOLITAN

RESEARCH—A HISTORY

It is in the middle of 1973, when the Governor of the

Department. Federal. Dr. Diego Arria Salicetti decided to
create an ambulance service that would respond as a priority to
emergencies that arose in different parts of the capital city and
that would depend on the DF Fire Department. To this end, the
General Commander of this body, Colonel LuÌs Montes
Meinhardt, is responsible for organizing said service.

Commander Montes Meinhardt selects

Captain (B) Dr. Jacinto Nouel Moros, - who at that time
had the dream of creating a service of this nature, within
the Fire Department since the beginning of the 70s, when
he had the opportunity to meet the Pre-Hospital
Emergency Medicine Service of the Fire Department of the
city of Miami, Florida (USA), its founder, doctor Dr.
Eugene
Nagel and the founding instructors of the service in this
city, Captain Randy Boaz and Inspector George Billberry; Likewise, he had
known the emergency services of the Jackson Memorial Hospital Complex,
which provided valuable support to this body. - to develop this ambitious
project and assigns responsibility for the academic training of staff, in the
respective area. Immediately, Captain Jacinto Nouel dedicates himself to the
preparation of the content

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 programmatic of the course that would be taught to previously selected
personnel.
This program was considered quite complete and was initially based on the
curricular content of the course taught at the City of Miami Fire Department,
due to the value of this experience, where it was established for the first time in
1970 under the ·standards of the College of Surgeons and the North American
Academy of Sciences, the first Pre-Hospital medical service.

Capt (B) Dr. Jacinto Nouel establishes contact with a group of

doctors belonging to the ìJ.M. Hospital. de Los Riosî, and
ìLuÌs Razettiî, to form part of the teaching staff that would take
on the challenge of academic training in the medical area, of
strictly selected firefighter personnel, as well as creating a
study curriculum adjusted to the demands of care pre-
hospitalization of patients in a state of emergency, which
would be the first
In our country.

Likewise, it invites a group of professionals from different disciplines to be

part of the Staff, thus completing the list of teachers who would tackle such a
beautiful project. Among these we can mention: lawyers, psychologists, police,
educators, nurses, etc.

Within the medical group there were various specialists, such as:
Traumatologists, surgeons, cardiologists, internists, intensivists,
anesthesiologists, psychiatrists, pediatricians, obstetricians, and others.

These personnel taught the medical part, the lawyers and the specialist
personnel in the police area were responsible for developing the legal, penal
and criminal aspects of the program, in order to provide abundant tools to the
students to be able to face the various situations that could arise. · Serve them
in the provision of the service.

Parallel to the beginning of academic activities, Captain J. Nouel was sent

along with Captain Germann Strauss, in the month of October 1973, to the city
of Melbourne, in the state of Florida (USA) to observe and evaluate the Ford
Econolite ambulance-type units, which were manufactured in that time for this
type of service. Captain Strauss had the mission of evaluating the mechanical
aspects of these units and Captain Nouel, the different devices and equipment
for the treatment and transfer of patients.

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 The first course began in September 1973 with an intensive nature. It lasted 90
academic hours and internships for 6 months, in the morning hours, in the
hospitals: ìJ.M, de los RÌosî, ìJ. MarÌa Vargasî, University student, ìMiguel
PÈrez CarreÒoî, PerifÈrico de Coche, ìJes˙s Yerenaî de LÌdice, and the
ConcepciÛn Palaciosî Maternity Hospital in the city of Caracas

The theoretical classes were held in the auditorium of the Cuartel Central ì
Victoriano Jord·n Pî from 7 at night until 12PM; However, the enthusiasm
was so great that many times it lasted until the early hours of the morning. The
afternoon was available to the students to study and rest.
This pace of study and practical work was maintained for 6 months.

The selection process for this personnel was very strict and was carried out as
follows:

96 permanent personnel presented themselves as candidates to join.

They underwent a battery of psychological tests that would yield results on;
their intellectual capacities, academic aptitudes, abilities and skills. They were
also interviewed personally, in order to observe and evaluate different
attitudinal aspects.

The result of this process concluded with the acceptance of 56 personnel to

begin the Intensive Emergency Medicine Course, with only 33 of them
successfully completing it. This first contingent of men graduated in February
1974, obtaining the certificate of "Emergency Medicine Technicians."

Among the group of doctors who made up the first teaching team are:
Dr. Gioconda de Lizarraga, Anesthesiologist, Dr. JosÈ Gonz·lez Cisneros -
Anesthesiologist, and Dr. LuÌs Ceballos Garcia - Plastic Surgeon at the JM de
los Rios Children's Hospital; Dr. Pedro Lizarraga ñ Cardiovascular Surgeon at
Vargas Hospital; Dr. Carlos Moros Ghersi ñ Internist. Director of the Vargas
School of Medicine; Dr. Alfredo Nouel ñ Pediatrician Neonatologist; Dr.
Miguel Yaber, Dr. Jacinto Nouel ñ Dentist Dr. VÌctor Rajbe ñ Obstetricians
and Gynecologists; Dr. Herber Stegeman ñ Psychiatrist; and Dr. EfraÌn Rio
Bueno ñ Pediatrician, Dr. Rodolfo BriceÒo ñ Pediatrician, Dr. Rodolfo
Cabanier ñ Traumatologist (these last ones from the CBDF Medical Service)
Among the non-medical teaching staff who participated in the development of
this first course are:
Commissioners Rafael Rivero MuÒoz and Gonzalo GirÛn (PTJ) who
developed very important topics such as: suicides, homicides
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 preservation of evidence, preservation of scenes, etc.; Nursing graduate Lucy
GutiÈrrez (Johnson and Johnson) who developed, among other aspects:
patient management and asepsis and antisepsis techniques; Mr. Domingo
MÈndez and JosÈ GÛmez (Transmission Emergency Corps) who developed
key aspects in the communications area such as radio management and
biomedical communications; Graduate in Education Gloria Carvajal de Nouel
who worked in the area of study methodology; Captain Gino Bonsanto Fornes
developed the legal aspects, which they had to know and handle appropriately.
Regarding the support material and support equipment, for the development of
the classes, there were films supplied by some medical laboratories in the
country, among them: Winthrop Laboratory, CIBA-GEIGY laboratory,
Johnson and Johnson laboratories, as well as the material physical and audio
visual of Captain Dr. Jacinto Nouel Moros. These may include: special
mannequins for resuscitation practices and venous access, anatomical models
of different organs, wound and fracture kits and specialized bibliography.

The excellent results obtained with this first group led to the petition to the
District Governor. Federal Dr. Diego Arria Salicetti, on behalf of the medical
teaching staff Drs: Jacinto Nouel, Pedro Lizarraga, Gioconda de Lizarraga,
JosÈ Gonz·lez Cisneros, LuÌs Ceballos Garcia, Alfredo Nouel and Herbert
Stegemann, of the creation of the nursing school of CBDF emergency and he
was also requested to include the hospitals under his responsibility in this
Emergency Medicine Plan.

Group of Instructors of the 1st Emergency Medicine Course

Firefighters
Chap. Jacinto Nouel M. Dentist
Chap. Gino Bonsanto Fornes Lawyer
Chap. German Straus - Mechanical Technician
Lt. Rodolfo BriceÒo - Pediatrician
Sub. Lt. HÈctor luÌs Garcia - Firefighter
Sgt. Efrain Rio Bueno. - Pediatrician
Sgt. Rodolfo Cabanier - Traumatologist
Sgt.2^ Alejandro MelÈndez - Radiocommunications
Medical staff
Dr. Gioconda de Lizarraga - Anesthesiologist
Dr. José Gonz·lez Cisneros - Anesthesiologist
Dr. Pedro Lizarraga ñ Cardiovascular Surgeon
Dr. LuÌs Ceballos – Plastic Surgeon
Dr. Carlos Moros Ghersi ñ Internist.

Dr Herber Steeman ñ Psi uiatra

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 Dr Alfredo Nouel - Neonatologist Dr. Miguel Yaber - Gynecologist Dr. VÌctor
Rajge - Gynecologist Dr. LuÌs Lovera - Internist Dr. Carlos Bocardo -
Internist Dr. LuÌs LÛpez - Internist Dr. MartÌnez Arteaga - Intensivist
Other Instructors

Rafael Rivero MuÒoz ñ Commissioner of the Judicial Technical Police

Gonzalo GirÛn ñ Commissioner of the Judicial Technical Police
Gloria C de Nouel ñ Graduate in Education
Lucy GutiÈrrez ñ Graduate in Nursing
Mr. Domingo MÈndez ñ Telecommunications Technician

Approved students who made up the first contingent of the

Emergency Ambulances:

MÈndez Rivas Eduardo Muller Salcedo. Ernesto. Anduela, José Manuel.

Hernandez Rooms. Adeliz.
Madrid. RamÛn.
Door. José.
Arguinzone Delgado Gustavo.
Romero MelÈndez, José. Blanco,
José Alberto.
Vargas, Carlos.
Moreno Vel·squez. Carlos.
Emperador Pino, Enrique Gedler,
Oscar Enrique García, Carlos
Milano, Pablo Antonio YÈpez,
Omar Colmenares, José. Nieto GÛmez, José.
Santana Morales, Eloy.
Rivero, José LuÌs. Curvelo, Juan.
Jimenez, Rodrigo Alberto Delgado, Julio.
Raposo, Cesar Guillermo. FermÌn Valles. Orlando.
Sotillo Acevedo, Pedro. Marcano Torres. Ruben.
Urbaneja Oscar Alejandro.
BolÌvar, José LuÌs. Castilian, Beloved.

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 MÈndez Guerrero, Carlos.
Montesinos, José Manuel.

Equipment with which the Units were equipped

1. Clinical Stretcher.
2. Portable Folding Military Stretcher.
3. Rigid Wooden Stretcher.
4. Fixed and portable oxygen cylinder.
5. Pneumatic ferrules.
6. First aid kit (equipped with vasoactive and special drugs used in
cardiovascular-cerebral resuscitation)
7. Amb˙ type Manual Resuscitators.
8. Fixed blood pressure monitor.
9. Blood pressure monitor and stethoscope case
10. Thermometers
11. Medical bag
1. 2. Metal ferrule for fixed elbow.
13. Minor surgery team.
14. Rolls of elastic bandages of different sizes.
15. Gauze boxes.
16. Lateral rays on top.
17. Electronic Siren.
18. radio transmission equipment
19. Ventilator in the patient cabin
20. Hooks for placing solutions.
21. Internal light for the patient and driver cabin.
22. CO2 extinguisher

BEGINNING OF THE SERVICE

The implementation of the service begins with the acquisition of 41 units of
FORD ECONOLITE ambulances from 1973, which are
received in 2 groups:
The first group consists of 20 units, then the remaining 21
are completed a year later. It should be noted that of the
second group, one of the
units was rejected for
having suffered damage to
the ship that would transport
be slinged to it.
Venezuela.

The first 5 units were

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 capital city, such as: Plaza Venezuela, Puente el Guan·bano, Plaza Catia and
La Vega. At first, there was a certain resistance and lack of collaboration on
the part of the medical and paramedical staff of the hospitals, towards the
service, obviously due to lack of sufficient information, not only about how
this service worked in other countries, but also about the professional
preparation received by the team of recently graduated boys. Later, with the
arrival of the new units, the need to start a 2nd course was raised, in view of
the urgency to place more trained personnel in the ambulances. Thus, when
this second contingent graduated, a third course was opened and in 1977 the
courses were suspended.
themsel
ves.
In November 1983, Lieutenant (B) Dr. José Gonz·lez
Cisneros scheduled a new course, which was authorized by
the education division and the command of the Fire
Department of the Federal District; It was submitted for
consideration at the UCV Faculty of Medicine, and was
approved by the DF Medical College.
At the end of the course and after having met the
requirements, the students received
a credential signed by the Dean of the UCV Faculty of Medicine, the president
of the DF Medical College, and the Commander of the Fire Department,
which accredited them as emergency medicine technicians.

The requirements demanded at that time were the following:

1 .- Be a Professional Firefighter
2 .- Be a Bachelor of the Republic
3 .- Have made the request in writing, before the Education Division of the
CBDF
4 .- Possess authorization from your superiors to take the course.
5 .- (2) front photographs
6 .- Have a minimum of 5 years in the Institution

In 1982, resident doctors were hired for communication and emergency care
via radio transmitter and in 1985 the government practically eliminated the
Pre-Hospital Emergency Service of the CBDF and it was taken over by the
Metropolitan Police with a service that became known as the SEM and SAM. ,
said service did not last long, returning it to the responsibility of the Fire
Department of the Federal District.

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 Prehospital Emergency Service Shoulder Patch until 2007

This service, during the different administrations of the DF government,

changed its name, for example Plan Caracas, SEM and SAM, Vida and others,
even though it never stopped being a Pre-Medical Emergency service. hospital
for the attention of the citizens of the DF, today the Metropolitan District.

In 1990, Dr. JosÈ Gonz·lez Cisneros of Prehospital Medicine edited a book on

the specialty for the use of students of this career with the name
"PREHOSPITAL EMERGENCY MEDICINE"

FOR CAR ACAS

METROPOLITAN MAYOR
FIREFIGHTERS BE CUR BE OS

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 Aeromedical
Department
Shoulder
Patch

Tunnel (B) J. Noah

Colonel (B) Dr. Tcnel (GN) Rafael Urdaneta
Pilots Group
Rodolfo BriceÒo G. A Pilot of the Air Division

DEPARTMENT REVIEW
AEROMEDICAL
 This department was created on January 23, 1991 and was made up of 10
firefighters divided into three guard sections with a supervisor responsible for
the group. They were stationed at the GeneralÌsimo Francisco de Miranda air
base (La Carlota).

A work team was formed with the pilot staff of the air division of the
Metropolitan Police in charge of Lt. Col. (GN) Rafael
Urdaneta Loyo.

Group of Fire Department Rear of the Volko

personnel
The air division of the Metropolitan Police assigned a Volko Helicopter (PM-
8) for the transfer and flight assistance of patients within the jurisdiction area
of the Federal District and neighboring states; such assistance pdf Machine - is
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 It was in charge of Emergency Medicine Technical Staff of the Federal
District Fire Department. Likewise, the fire department assigned, for ground
transfers from the airport to hospitals, an ambulance unit with special
characteristics due to its size and equipment carried and a unit for coordination
and supervision on the ground.

The firefighter personnel, with the exception of the drivers, had university courses
such as Emergency Medicine Technicians with a duration of one year at the
Central University of Venezuela and internships in different hospitals, most of
them complemented their preparation with other specialization courses such such
as trauma shock (5 personnel), aeronautical medicine (2), scuba diving and
underwater rescue (3 personnel), explosives specialists (1 personnel), Ophidiology
(5 personnel), rescue and survival in jungle and mountainous areas, etc. The
drivers completed basic training in emergency medicine and defensive driving.

The technical staff in Emergency Medicine had a minimum of 4 years and a

maximum of 8 years of experience, so we were aware that we had highly qualified
personnel in this area. This service provided its functions during the working
hours of the air base.
The supervisor of the air department had the following functions:
The control, evaluation, assistance and feedback of knowledge of the personnel
under his command. Supervision of equipment, materials and medical supplies of
the department. Supervision of ground units and supervision of daily service
operations.

In 2002, the Aeromedical Department of the Prehospital Emergency Medicine area

of the Fire Department of the Federal District stopped providing service.

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