The “Little Program That Could”: Celebrating 46 Years of Pre-Hospital Cardiac Care

Forty-six years ago, something extraordinary happened on the streets of Oshawa. 

On December 3, 1979, sixteen specially trained Oshawa Ambulance Attendants stepped into a brand-new role — one that would change cardiac care in our community forever. It was the launch of the Pre-Hospital Cardiac Care Program (PHCC), an innovative initiative that brought advanced cardiac care directly to patients before they even reached the hospital. 

It was a bold idea. And at the time, it was revolutionary. 

A Vision Born in the Emergency Department 

The program was the brainchild of Dr. John Forsyth, who saw firsthand in the Emergency Department at Oshawa General Hospital that too many cardiac patients were arriving too late — dying or already deceased by the time they reached care. 

Dr. Forsyth believed something could — and should — be done. 

He approached Drew Duncan, Manager of the Oshawa Ambulance Service, with a proposal: what if ambulance attendants could begin cardiac assessment and treatment in the field? What if care didn’t have to wait for hospital doors to open? 

It was a simple but transformative question. 

Proving the Need 

Before the program officially launched, groundwork was already underway. For a full year, attendants carried half of a LifePak 5 monitor and completed 3-lead EKGs on every patient experiencing chest pain. The data confirmed what Dr. Forsyth suspected — earlier intervention could make a difference. 

With need established, training began in earnest. 

The education effort was truly collaborative. The Continuing Education Department at Oshawa General Hospital, members of the IV Team, and Emergency Department physicians all played a role in preparing the attendants for this expanded scope of care. It was a shared commitment to improving outcomes for cardiac patients in Durham Region. 

A Program That Almost Didn’t Launch 

The original start date was set for January 1, 1980. But when a new Chief-of-Staff — unfamiliar with the program and its rationale — declined to permit it to proceed, the team found a creative solution. 

They moved faster. 

Rather than delay, the program rolled out earlier — on December 3, 1979. 

Those early days required ingenuity. Drug bags were improvised from camera bags purchased at Bernie’s Cameras on King Street. EKG leads were stored in a men’s shaving kit from Zellers. Medications, IV supplies and lines were provided by Oshawa General Hospital. 

It wasn’t flashy. It wasn’t polished. 

But it worked.