When I started in EMS, the term “EMS Sports Pages” referred to the Obituaries. It was where we turned to see how our critical patients did. Get pulses back on a cardiac arrest or bring in an unresponsive patient with multiple trauma from an MVA or a seizing patient with left sided paralysis, you checked…
A new article* published in Prehospital Emergency Care (on-line April 8, 2016), concludes that Basic EMTs can safely give subcutaneous Fentanyl for acute pain in the prehospital setting. *Subcutaneous Fentanyl: A Novel Approach for Pain Management in a Rural and Suburban Prehospital Setting BLS EMTs in Canada received a four hour training course, and then…
I wrote this a couple months ago when I was feeling really burned out. The burnout passed, as I knew it would, and I am back to myself, so I can post it now. (1) I have been responding to 911 calls for twenty-six years, 21 as a full time paramedic with a busy urban commercial…
This past year has been a banner year for new EMS books, memoirs and fiction. Each book that reaches an audience outside of the EMS world increases the public’s understanding of what we do and hopefully, increases their respect for us. Here is a roundup of recent books. Lights and Sirens: The Education of a…
Two tattooed muscle head dudes in their twenties, one a convicted felon, who used to work construction as well as sell steroids, started a small business in which they hired a doctor to write prescriptions for pain medicine to most anyone who came through the clinic’s doors during business hours. The doctors got $75 a…
I wrote recently about my new found concern about giving opiates to patients with chronic pain. Opiates for Chronic Pain Subsequently as a member of our regional medical advisory committee, I submitted the following draft proposal: Paramedic Chronic Pain Management Guidelines (Draft) Providing opiates to certain patients with chronic pain conditions may not always be…
Check out this NPR radio podcast: Do You Think Your Heart is Healthy? I was fortunate enough to be asked to be one of three guests on the Colin McEnroe Show this week. I was on to talk about what people can do during a cardiac emergency from a paramedic’s perspective. Thanks to Colin and…
Should paramedics give opiates to patients with chronic pain? I want the answer to this question. Now, until recently I have not questioned this practice. Today, I still medicate (well, most*) patients with chronic pain of 4 or more, who do not have contraindications, and who say yes when I ask them if they want…
The heroin epidemic is getting a lot of play in Connecticut. In 2015, according to the latest numbers there were 415 heroin deaths in the state, triple the number three years ago. There is a bill in the legislature to require all first responding agencies in the state to carry naloxone. Here’s a news article…
An EMS memoir can take any form, but there are usually only two. 1) The Newbie enters strange new world of EMS, struggles to prove self, and in the end makes good. 2) The Old Dinosaur looks back on his career, telling tales, etc. Sometimes the two are combined together. In the nonfiction books, the…
If you have access to HBO, you should watch their new documentary Heroin: Cape Cod, USA. It is also an excellent companion to the book Dreamland: The True Tale of America’s Opiate Epidemic, which details the rise of pain pill addiction and the resulting shift over to heroin among the pill abusers. The documentary follows…
Three sets of footprints in the snow. Two with fully defined treads. Mine barely register. I’m twelve years older than the two of my partners combined. This is my fifth pair of boots and the soles have gone smooth. I walk carefully. We do a call and I can’t make it up the icy driveway….
In my standard talk urging paramedics to be generous with pain management, I have a section called pain myths. One of the myths is entitled Fear of Creating Addicts On the powerpoint I have two pictures, one of an all-American housewife, the other of a skanky drug-addled prostitute. Here is the text from the slide:…
When couples get old, they communicate with fewer words or sometimes just a look. I am feeling that way about my EMS reports at the ED. Where I used to rattle off every detail I could think of (from brand of cereal they had for breakfast to the number and locations of the moles they had…
I once did 10 cardiac arrests in one day. They were all v-fib arrests. I managed each code from the moment I arrived to find CPR in progress to the moment the patients were whisked off to the cardiac cath lab. I got 10 successful ET tubes, and despite the studies that show ET intubation…
A few days ago on our employees only Facebook page, someone posted a picture another person had taken of one of our crews while they were parked by the side of a street. The driver leaned against the window, arms folded, eyes closed. The passenger had his eyes open, but he was slouched down in…
On Sports Radio this morning they were talking about the decline of three sports legends – Tiger Woods, Peyton Manning and Kobe Bryant. The radio host, a retired athlete himself, was saying how no one who hadn’t played professional sports could possibly understand what these three were going through. He said they dedicated their lives…
In our state (Connecticut), BLS (with sponsor hospital approval) can do the following life-saving interventions: Defibrillate with AED Give Epinephrine in Anaphylaxis Apply CPAP to Severe Respiratory Distress Give Narcan to Hypoventilating Opiate Overdoses Give ASA to Chest Pain. Transmit 12-lead ECG Speed Trauma and Stroke Patients to the Hospital Here’s what They Can’t Do:…
The long wait is over. The AHA 2015 CPR and ECC guidelines are finally here. For the first time in many cycles, there are few changes. No, you will not have to relearn CPR, and your drug kits will not see an overhaul. The guidelines finally offer a lukewarm acceptance (“it may be reasonable”) to…
People are always asking me what changes I have seen over the years. Here are four changes I have been thinking about lately. More paramedics. When I started we had anywhere from two to six paramedics on to cover the entire city of Hartford and backup the other three large towns we covered. On many…