EMS Hall of Fame: The Pioneers of Prehospital Care—Zoll, Schaefer

The short history of EMS has been driven by the wisdom, foresight, and innovation of countless individuals. As the field ages into its second half-century and its origins fade to the past, it’s worth commemorating the greatest pioneers of prehospital emergency medical services. This series honors these trailblazers. 

Paul Zoll 

Pacing, defibrillation leader

Paul Maurice Zoll, born in 1911, was an American cardiologist and pioneer in the development of the artificial cardiac pacemaker and cardiac defibrillator. In 1980 he cofounded ZOLL Medical Corp., which remains a major provider of resuscitation and critical care solutions today. 

After medical school Zoll served as an army physician during World War II, rising to chief of medicine at the 160th general hospital, which was designated for combat casualties with chest injuries. While successful heart surgery had been rare until that point, he and chest surgeon Dwight Harken removed bullets and shrapnel from in and around the hearts and great vessels of 138 soldiers without a fatality. 

A presentation at a 1950 American College of Surgeons meeting prompted Zoll to develop a technique for pacing the heart through the intact chest during asystole. In a 1952 article he described cardiac resuscitation via electrodes on the bare chest, helping prompt resuscitation leaders to more widely embrace the concept of pacing. Subsequently Zoll described a mechanical technique for stimulating the asystolic heart and an approach to terminating v-fib with a large chest surface shock. With colleagues he also developed a way to display the heart’s electrical activity on an oscilloscopic screen, paving the way for cardiac monitors. 

In 1960 Zoll discovered external countershock could terminate supraventricular tachycardia and ventricular tachycardia. By 1964 he’d developed a method for long-term direct heart stimulation through an implanted pacemaker. The NTP 1000 temporary pacemaker that emerged from this research helped establish ZOLL Medical in the early ’80s. 

Zoll retired from practice in 1993 and died of pneumonia in 1999. 

Walter Schaefer 

Air-medical pioneer

Walter Schaefer, a German immigrant who’d worked as an undertaker, founded the California ambulance service that later bore his name as Hollywood Ambulance in 1932 and went on to achieve a number of firsts in American EMS. Schaefer Ambulance, as it was ultimately known, was the first U.S. service to provide critical care transportation and fielded the first FAA-certified air ambulance service in the United States. 

Schaefer Ambulance served citizens in six Southern California counties (Los Angeles, Orange, Ventura, San Bernardino, San Diego, and Imperial) and lasted more than eight decades before ceasing operations in 2019. Schaefer himself “took pride in being an industry leader… [and] believed in sharing his vision and knowledge with others,” the company notes on its website. He was the founding president of both the California Ambulance Association in 1948 and the American Ambulance Association in 1979. 

Hollywood Ambulance started with a single six-year-old vehicle but by its peak it grew to 100 ambulances and was run by Schaefer’s children after his death in 1986. 

The first documented use of an air ambulance was during the Prussian siege of Paris in 1870, and planes took over by 1917, but medevac capabilities didn’t come to American civilians until after World War II. The provincial government of Saskatchewan, Canada, launched a service in Regina the year before Schaefer started in the U.S. Paramedicine hadn’t been developed yet, however, meaning that unless a patient were accompanied by a physician or nurse, such early flights were transportation only. 

Today in the U.S., helicopters and airplanes perform an estimated half-million transports per year. 

John Erich is the senior editor of EMS World.