The official death numbers for 2018 are out from the Connecticut Medical Examiner’s office. Connecticut Accidental Drug Intoxication Deaths 1017 people died in Connecticut of accidental overdoses, down 21 from 2017. This is the first decline (albeit minor) after six years of escalation. 746 people died in Connecticut due to the presence of Fentanyl, up…
I wrote a number of months ago about fentanyl induced chest wall rigidity in opioid overdoses. Chest Wall Rigidity Fentanyl induced chest wall rigidity is rare in the hospital setting, but it should not be surprising to find it is a factor in overdose outside the hospital given that the amounts of fentanyl being injected…
I first picked Veronica up on Hungerford Street one afternoon two years ago. We had been called for an unresponsive, but instead, we found a small woman with a club foot staggering along the street. She was half on the nod and covered with leaves. I asked her if she was okay, as we walked…
How do you want to be known as a Paramedic/EMT? A. Reliable B. Frequently wrong According to a recent article in JEMS, Ditch the Machine to Improve Accuracy in Blood Pressure Measurement and Diagnostics, “automated blood pressure readings are frequently inaccurate.” Is this a surprise to anyone? Yet, many of us continue to relay on automated…
December 8, 2018: This weekend, I am in Worcester, Massachusetts at the New England Short Course Meters Masters Swimming Championships as a member of the Connecticut (CONN) team. Last year, we shocked many of the other teams by taking first place. Points are awarded based on place finish in individual and relay events. Each swimmer…
When they can’t get a hold of their local dealer, the two young men come in to Hartford from the suburbs to buy cocaine. Bart boasted to a younger friend Milton that he could get any drug he wanted on Park Street. “Well, let’s do it,” Milton said. It is true that Bart knows where…
We’re sent to the courthouse where a marshal takes us back to a holding cell. A thin, bearded man with cuffs around his wrists and his legs chained is bent over in the bare cell, grimacing. “Guess he got nervous about seeing the judge,” the marshal says to us, “Developed himself some back pain.” “I’ve…
He is walking down a side street off Park when he freezes in place. He sees the slow moving black Toyota blink its lights, then he sees the station wagon. Before he can take a step to flee, he sees the barrel come out of the back window. He feels the impact against his shin…
I see Maria outside the Spanish market, squatting against the building. She is a tiny woman in her fifties who was introduced to heroin thirty years ago when she was living in New York. The father of her son used it occasionally and when he used, she was obligated to sniff some as well. It…
A walk in the park to stretch the legs while on post. The medic walks past a row of port o-potties from a weekend event. One port-o-potty is not fully closed. A sneaker blocks the door door. On second glance the sneaker is attached to a foot. Open the door and an unresponsive man tumbles…
Misinformation and inconsistent recommendations regarding fentanyl have resulted in confusion in the first responder community. – Fentanyl Safety Recommendations for First Responders (Revised) from the Office of National Drug Control Policy. It seems every week responders are getting exposed to Fentanyl, being rushed to the hospital, with many getting Narcan, all often without exhibiting any symptoms or…
I wrote an op-ed this month that was published by the Hartford Courant. Insight: I See What Heroin Does. Let People Shoot Up Safely Included was a checklist: 5 Things to Know About Heroin Addiction I read an article a few days later that said that when called an “overdose prevention site,” as opposed to…
The use of epinephrine in prehospital cardiac arrest showed no difference versus placebo in determining favorable neurological outcome according to a long awaited randomized controlled study published yesterday (July 18, 2018) in the New England Medical Journal. The trial showed epinephrine produced a higher rate of survival at 30 days than placebo, but that was…
Kelly is as dispirited as I have seen her. “My veins are shot,” she says. “I can’t even get high.” IV users use 1 cc syringes which have a very small needle they only need to slip inside the vein. When they pull back and get blood they know they are in. They push the…
She finds him in the bathroom at seven in the morning and knows immediately he is using heroin again. Three weeks ago, they moved east from Seattle. She had a job offer and it also represented a chance to get him away from his junky friends. After three times in rehab, she didn’t think she…
The man is trembling, sitting on the bed in the spare motel room down by the highway. Sometimes, these rooms are filled with the patient’s worldly belongings, but this room seems to only have the bed, a dresser, a chair and the TV. The man is in his late fifties, a portly man with white…
The man is on the nod, the only thing keeping him up is the fence he is leaning against. When the police officer tries to extricate him from the fence, he falls back and the officer has to lower him to the ground. I set my red bag down to get out my ambu-bag, but…
One of my EMS coworkers and a budding journalist Sean Freiman interviewed me recently about Hartford’s Opioid Crisis with a focus on the heroin bags. Click on the picture to view the interview.
Overdose on Babcock Street. In an alley behind a building. Fire is there before us. A familiar scene. As I approach I can see them hunched over the patient, the bag valve mask out. They have already given her four of narcan. I stand over them looking at the patient. I can’t see her face…
Opioid deaths are generally classified as accidental overdoses. In 2017 Massachusetts began reporting opioid deaths as “All Intents” where they previously reported them as “Unintentional/Undetermined.” They point out that adding suicide deaths only marginally adds to the count. By their statistics only 2 percent of the total opioid deaths were confirmed as suicides. Massachusetts Opioid…