A medical doctor and surgeon, McSwain was on the faculty of the University of Kansas when in 1973, he was asked to help educate a new class of medical professional: paramedics. He visited Los Angeles and Seattle to evaluate their systems, and within four years, 90 percent of the Kansas population had a paramedic within a 10-minute response, and one out of every 500 Kansans, including the entire Kansas Highway Patrol, was trained as a basic Emergency Medical Technician. That impressed the city of New Orleans, which recruited Dr. McSwain to start a paramedic program there. When he arrived, “there were 44 separate emergency numbers that could be called, just within Orleans Parish,” to get an ambulance, he said a few years later — there was no “911” system there yet. He quickly instituted a centralized dispatch, with trained EMTs to answer calls for help.
The American College of Surgeons Committee on Trauma also recruited him to help develop the Advanced Trauma Life Support program, which was the basis for the Pre-Hospital Trauma Life Support program; PHTLS is now considered to be the world standard for pre-hospital trauma (injury) care. He also trained the U.S. military, developing the Tactical Combat Casualty Care program for combat medics. McSwain went through paramedic training himself, and sometimes worked in the field, to be fully versed on the realities faced in the streets. One such experience led him to create the “McSwain Dart” to treat tension pneumothorax (collapsed lung) in the field. McSwain then bundled all of this experience together to help him write textbooks for field medics. He is the only doctor to have received all five major awards for trauma given by the American College of Surgeons. Dr. McSwain died in New Orleans on July 28 after suffering a stroke. He was 78.