As recently as the 1960s, a patient being rushed to the hospital with crushing chest pain would be treated en route only with sirens and sympathy.
Alarmed by high death rates and encouraged by new technology, a small group of pioneering physicians started equipping ambulances with defibrillators and paramedics who knew how to use them. Although today the idea seems straightforward, it was a radical departure from established protocols and was credited with saving countless lives.
"What it all means is that if you have any regard for your health and are over 40, you ought to move to Los Angeles," Dr. Walter S. Graf told The Times in 1978. "Your chances for avoiding sudden death are enhanced."
Graf, a cardiologist who helped establish the modern system of paramedic emergency care, died Oct. 18 at his Los Angeles home, family members said. He was 98.
Graf was former chief of staff for the Daniel Freeman Hospital. In the 1960s, he established what was thought to be the West Coast's first dedicated coronary care units there and later created the groundbreaking Daniel Freeman Paramedic Training Program. In 1999, it merged with the UCLA Center for Prehospital Care.
In 1969, Graf, who was then president of the Los Angeles chapter of the American Heart Assn., converted a white Chevy van into a "mobile critical care unit."
The idea was to speed to heart attack calls with a Daniel Freeman nurse and a portable defibrillator. Later, training was expanded to include firefighters and emergency medical technicians — groups that, according to Graf's studies, performed just as well as nurses at saving cardiac patients.