I have been writing much lately about heroin with the backdrop of Hartford’s Park Street which is one of many epicenters of the current heroin epidemic. Today, I am going to briefly change the backgrounds. Instead of Park Street with its back drop of bakeries, bodegas, Spanish restaurants, and young tattooed men, with crooked baseball…
Author: medicscribe
Dead Man
I mentioned that we had a patient this week who said she stayed away from the white powdered heroin because of her fear of Fentanyl. Powdered Fentanyl is white and very hard to distinguish visually from white powdered heroin. A number of years ago drug dealers started enhancing their heroin with Fentanyl. Fentanyl is stronger…
Park Street
I only went to one heroin overdose this week and one PCP overdose. The heroin overdose was on Park Street in the South end and the PCP was on Capen in the north end. You get get called for an overdose on Park Street and it is pretty much always heroin. You get called for…
The Finger
I have been injured seriously enough to miss work twice in the last two decades. Â Neither time was I injured on the job. Â The first injury was playing softball on our ambulance team (back when we had one). IÂ went from first to third on a single, and as the third base coach signaled me to…
OMG
Two weeks ago, it was Black Jack. This week it is OMG. Oh, My G**. The woman lays on a parking lot sidewalk behind the school. Her face is blue and she is only breathing one or two times a minute. She is wearing tight spandex and bright pink tank top. She has tattoos on…
Black Jack
I did three heroin ODs on one shift last week. Another medic did four in a shift the day before. Lots of OD calls going out. All three of these ODs used the same brand. Black Jack. For years, dealers in the Northeast have been branding their supply, stamping or printing it on the glassine…
Three Lives
The heroin epidemic continues unabated in Hartford. I called the time on two fatal overdoses in a recent week. Both men were in their 40’s. One was in a low-rate motel. He sat by the window in his breeze-less room, the curtains pulled just enough so he could see the cars rolling past on the…
Cat Burglar
One of my greatest joys on the job is the opportunity to play cat burglar. By this I do not mean the opportunity to break into homes to steal jewelry and works of art. I am talking about the chance to break into homes to rescue people (with police permission). The person has fallen and…
Sinners and Saints
As each of us will ultimately find ourselves before our god, many will find themselves before their paramedic. But unlike their god, their paramedic does not sit in judgement. We treat all of our patients the same. That is the creed. The man in the Mercedes Benz gets the same care as the man pushing…
Conrad Castonguay
Conrad Castonguay died this week at 81. In 1992-93, he helped teach my paramedic class. Pharmacology was his specialty. He wasn’t a paramedic, but he knew what he was talking about and we paid him mind. He was a challenging instructor, and took his work seriously. It became an honor for paramedics to say they…
EMS Sports Pages
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…
BLS Fentanyl
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…
Burnout (with Footnotes)
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…
New EMS Books
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…
American Pain
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…
EMS Opiates and Chronic Pain – 2
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…
Do You Think Your Heart is Healthy?
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…
Opiates for Chronic Pain
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…
Drug Addicts
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…
EMS Memoirs/EMS Fiction
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…