Author: medicscribe

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…

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…

She curls on the couch sobbing. She found her son not breathing when she came home from her midnight shift. He is on the floor now.  The fire department first responders do compressions on his bare chest. The man is lean and muscled with jailhouse tattoos on his arms, chest, and neck. It isn’t a…

An older man with a cell phone meets us at the door to the apartment lobby. His hands shake. He motions for us to follow toward the stairs. “What’s going on?” I ask. “I just went out for ten minutes and I came back and found him.” “Is he breathing?” I ask. But he does…

You are called for a seizure in the men’s room at McDonald’s. You arrive to find an approximately thirty-year old man stiff and purple, gurgling. “Versed?” Your paramedic student says as you break out an ambu-bag. “Check his pupils.” “Pinpoint.” You hand him Naloxone. “Give him 1.2 IM,” you say. He looks at you like…

There is an anxious crowd on the corner of Hungerford as we come lights and sirens down Park Street.  A woman with tattooed arms waves for us to hurry.   A man is on the ground with a crowd clustered around him.   I can see another man kneeling over his chest. His arms together like he…

“I’m a shit bag,” he says to me.  “I’m supposed to be taking my boy trick or treating tonight.  I can’t fucking believe I did this.  You said I wasn’t breathing?  After all I’ve been through to die like this.  Fuck me.  I’ve got shit for brains.” The young man got out of jail an…

The man kneels in the grass next the pickup truck that has its door open. He vomits.  The fire department is standing over him.  “Citizen Narcan found him in the truck passed out, squirted him with two doses and then took off when we got here,” a firefighter tells me. I see the two 4…

Finally! The Federal Government has listened to the experts and released sensible evidenced-based recommendations on safety for first responders when encountering fentanyl and fentanyl analogues, including carfentanil. Fentanyl Safety for First Responders The document issued yesterday by the White House National Security Council is the product of their Federal Interagency Working group with collaborative support…

The call is for an overdose in the stairwell of the apartment building. Fire has arrived just before us – they have propped the front door open. I enter with my house bag over my shoulder and carrying the cardiac monitor in my right hand. There is no one in the dim lobby to direct…

“Falsehood flies, and truth comes limping after it, so that when men come to be undeceived, it is too late; the jest is over, and the tale hath had its effect.” – Jonathan Swift This quote came to me from a respected toxicologist after reading some news accounts of public safety response to possible fentanyl overdose…