I recieved email this week from a Denver paramedic working to promote paramedic awareness and recruitment, asking me to post a Youtube link. On it there are a number of excellent videos.
Author: medicscribe
Community
Last week I had the privilege of attending a ceremony in which a town received a Heart Safe Community designation, which goes to towns who meet certain criteria in terms of their EMS systems and availability of training, education and public access defibrillators and other factors affecting the Chain of Survival. At this particular ceremony there were…
Youth
The mat outside the apartment door says “Coors Country.” Inside the door there are two empty cases of beer; Bud Light and Heinekin. There are two plastic garbage bags tied up and ready to be taken down to the parking lot dumpster. Straight ahead there is an open kitchen with a bar counter. Lined up…
Up the Stairs
Saturday night. 9:30. A half an hour before I get off after a 16 hour shift. It’s the worst time to get a call. Another fifteen minutes later and my relief would be in and he’d take it, but at 9:30, no such luck. I am definitely getting off late. The call is for a…
Katherine Ann
Let's Go to the Tape
If we can use digital cameras to capture pictures of crashed cars to show the trauma team, can we use video cameras to record our patients’ “seizures” for later rebroadcast — not on You Tube, but for the patient’s ED doctor and consulting neurologist?
Respect
We went to a doctor’s office for an unknown. The secretary led us to an exam room where a man in his sixties sat in a wheelchair, his chin on his chest, eyes closed, looking very tired. He had a huge distended abdomen and a hint of a yellow tinge to his skin. His wife…
The Essential Eight
We have reached the Essential Eight — eights drugs that I am not going on the road without.
Aspirin
Now Aspirin use has become so prominent that many of my patients have already taken Aspirin before I get there — either they took it themselves, were given it by a friend or coworker or a medical professional on the scene gave it to them. When I do bring them to the hospital, the first question I am asked is “Did they get Aspirin?”
Atropine
The best bradycardia calls are for the patient passed out in the bathroom. You find them on the floor, cold and clammy, no pressure, pulse in the 20’s. We used to give a full amp of Atropine, now we give 0.5, and if that doesn’t work another 0.5 mg, etc. A couple times I have given the full 1 mg by mistake. Old dogs. Still the drug works well, the pulse picks up, the patient wakes up, the skin colors up and drys out and all is well in paramedic land. “You fixed them,” the doctor says to me in the ED. Music to my ears.
Dopamine
We don’t carry med pumps so the drip is pretty much of an eyeball, and then titrate to blood pressure. When the pressure bottoms, you bump it up. You get a pressure above 90, you ease it down.
Glucagon
My secret EMS pride has always been my IV skills. I like to think of myself as a Zen master of IVs. And so I know I am hexing myself when I write this — I know somewhere out there right now a diabetic with no veins is slipping into unconciousness, and I will be summoned to perform, and then empty catheter wrappers all around me, I will despair to the heavens that I have lost my IV karma and at last reach into my kit for the Glucagon.
20 Drugs To Go
Now as we move up the list toward what I call The Essential Eight, the choices are going to become harder.
Metoprolol
“So, the Metoprolol finally worked,” I said to the nurse.
“No,” she said, “We gave him Cardizem.”
Toradol
When Fentanyl arrives in my kit, it will likely be ranked quite high on my list and push Toradol down even further, possibly to the point where we will have no need to carry it.
Activated Charcoal
I must confess that in my 21 years riding ambulances, 18 as a paramedic, I have never given Activated Charcoal to a patient.
Vasopressin
“In summary, the use of vasopressin alone or in combination with epinephrine as the first line vasopressors during resuscitation from cardiac arrest offers no benefit related to short- and long-term survival compared to the use of epinephrine alone.”
Upstairs
The asphalt is white with salt. What grass pokes out from the crusted snow is a dull yellow. The houses in this lower middle class neighborhood are all grey. Walking up to house, I am struck by the only color I have seen for days. On a concrete slab of a driveway there is a…
Dueling Coughs
“You sound worse than I do,” my patient said to me this morning. “How about we draw straws to see who gets seen at the ED first,” I said. My cough is actually improved from a week ago. My preceptee was treating a lady with chest pain who had a deep rattling cough. I was…
Glimpse of the End
Let me say right from the outset that I love being a paramedic and dread that day that I can no longer do this work. That said I have had two moments in my career where I have glimpsed that day. These moments are not moments that you would expect. It was not a bloody,…