Rade B. Vukmir, MD, JD, FCCP, FACEP, FACHE, is an emergency and critical care physician and one of the first trained and certified EM intensivists in this country. He is national medical director of critical care medicine and chief clinical officer of patient safety organization for Schumacher Clinical Partners. He also serves as adjunct professor of emergency medicine at Temple University in Philadelphia. He has been practicing intensive care medicine since the 1989 and was the founder of the ACEP Critical Care Medicine (CCM) Section. Dr. Vukmir recently sat down with Joseph E. Tonna, MD, secretary of the ACEP CCM Section and editor of its newsletter, The Unit, to discuss about the history of EM/CCM and the ACEP CCM section and how his career path led him to the interface of EM and CCM. Here are some excerpts from the conversation.

JT: Tell me about the history of the ACEP CCM Section and of the feeling among its first members. Who were they?

RV: It will help to offer a historical perspective, as these issues are related. When you look at emergency medicine and critical care, the founders always thought that the interface of emergency medicine and critical care was a logical one. It was Peter Safar and, subsequently, Ake Grenvik that truly appreciated the multidisciplinary nature of critical care, with the natural fit of emergency medicine as they developed their critical care vision. If you think about emergency medicine and critical care, the concept of surgical critical care in general and the emergency medicine-critical care interface were both born, in some ways, in Pittsburgh.

Peter Safar came to the University of Pittsburgh in the 1960s, became the chairman of the department of anesthesiology, where he established the first CCM training program. When he came, in the 60s, one of the things that he did was establish essentially the first EMT/paramedic training program in the country, and created the first van style ambulance with cardiac monitoring capability that was a minority staffed and run program, and it used “advanced resuscitation techniques” at the time. This was instead of getting thrown into the back of the hearse-style ambulance, which is what they did up into the mid 1960s. The first medical director for Pittsburgh’s Freedom House Ambulance Service was Nancy Caroline, the first EM/CCM fellow in 1974. So, when you look at the emergency medicine contribution to critical care training, Peter always felt that emergency medicine with critical care was a natural interface.