In this post, I will explain how opioids affect the brain, what steps you should take to reverse an overdose, how naloxone works and where it can be obtained, and what to do in the immediate aftermath of overdose. How Opioids Kill Opioids kill by shutting down our breathing or slowing it to a rate…
The third and deadliest wave of the opioid epidemic began in 2013 with the increasing adulteration of the heroin supply with illegally produced fentanyl. Fentanyl is a synthetic opioid manufactured in laboratories. Fentanyl was approved by the US Food and Drug Administration in 1968. It is a pain killer, with a rapid onset and a…
I recently had a patient who still had his discharge papers on him from a recent trip to the ED following an overdose. The instructions were fairly simple. Please do not use fentanyl again. If you are looking for any sponsors or help we do recommend that you purse Narcotics Anonymous. He admitted that he…
I participated in a powerful documentary about the Fentanyl epidemic in Hartford. The documentary is part of the Frontlines docuseries by Kennard Ray exploring life in Hartford. It focuses on the frontline harm reduction workers and their clients in the battle to keep people alive.
I joined Twitter a year or so ago, and while I am not crazy for the app, every now and then, there is a really good thread. Recently I found one started by HighPerformance EMS. One of the greatest privileges of this job is having conversations with your patients who have lived amazing lives. There…
Two paramedics in Illinois were charged with first degree murder of their patient, a 35-year-old man reportedly experiencing alcohol withdrawal. The paramedics did not put a Berretta to the man’s head and pull the trigger nor did they stab him repeatedly with a Bowie knife. Police body camera footage shows they were rude to him,…
The on-field cardiac arrest of 24-year-old Buffalo Bills safety Damar Hamlin on Monday Night Football captured the attention of our sports-watching nation. The TV producers were hailed for their decision not to continually reshow the clip or show closeups of the rescue on the field. I understand medical privacy rights and as a working paramedic…
I recently worked with the New England High Intensity Drug Trafficking Area (HIDTA) Health and Public Safety Analysts to put together a Naloxone training video aimed at Connecticut first responders, the type of video that can be played during roll call at the start of a shift. It was great working with the HIDTA people…
With Emergency Departments becoming increasingly crowded and extended EMS wall time becoming more common, I raise the question should EMS ever bring their equipment into the hospital to treat their patient while waiting for bed assignment and transfer of care? I am not talking about continuing treatments such as oxygen or a medication drip started…
In 1988, from my second story apartment over a liquor store on Springfield’s Main Street, I watched a paramedic and his partner attend to the chaos at the accident scene below as the red strobes of their ambulance lights illuminated the street. Then for just a moment, the paramedic, a tall roughened man in his…
This is an old Christmas story I wrote years ago, reposted now. ***Fifteen on the Scale It’s Christmas eve. We get called to one of the local nursing homes for rib pain. The room number sounds familiar. As we wheel our stretcher through the lobby, “Good King Wencelous” plays through the speakers. Gently shone the…
Time for Christmas Shopping. If you enjoy my blog, please consider buying some of my books either for yourself or friends. They are all available on Amazon or to order at your local bookstore. Killing Season: A Paramedic’s Dispatches from the Front Lines of the Opioid Epidemic, (selected by Amazon as one of the best…
I wrote this post on Thanksgiving 2005. *** It’s Thanksgiving morning. I awake at 5:10, shower and dress, then open up the garage door to see a couple inches of snow on the ground. It’s beautiful, but I hate winter, hate the cold weather, hate driving in snow. When I get to the base, I can see…
I am pleased to announce, the EMS Novels, Mortal Men (2012) and Diamond in the Rough (2016) are now available in paperback from Amazon.com or for order at your local bookstore. *** Mortal Men is a novel about paramedics in Hartford, Connecticut in the 1990s when a gang war was raging in the city. It…
Patient cool, clammy, diaphoretic with sudden crushing chest pain, family history of MI. We do a 12-Lead ECG. If the 12-lead shows ST elevation of ≥1 mm in 2 contiguous limb leads or 2 mm of ST segment elevation in 2 contiguous precordial leads, we take the patient to a hospital capable of percutaneous coronary…
A fellow medic told me about a cardiac arrest he did recently where in the middle of CPR, the patient opened his eyes and flailed his arms. He and his partner stopped CPR thinking they had achieved Return of Spontaneous Circulation (ROSC), but the patient slowly went unresponsive, and when he checked for a pulse,…
So I finally got to watch the Ambulance movie, now that it is available for free streaming on Amazon Prime. I did not have high expectations for the thriller (having seen the trailer), but I am always interested in how EMS is portrayed by Hollywood. The movie is simply one long chase scene as the…
Earlier this month in Connecticut law enforcement arrested two men from Maryland for having 15,000 blue Fentanyl pills hidden in Nerds and Skittles candy wrappers. This was not the rainbow fentanyl (multicolored pills), just regular blue counterfeit oxycodone 30’s hidden in candy packaging to elude law enforcement. Nevertheless, news coverage following their indictment this week…
The DEA recently warned Americans about rainbow fentanyl, multicolored pills, powders and blocks containing fentanyl that the agency said were “a deliberate effort by drug traffickers to drive addiction amongst kids and young adults.” We haven’t seen the rainbow pills in our area (Connecticut) although we have seen quite a lot of blue and purple…
I turned 64 recently. Happy Birthday to me. A couple weeks ago, on two occasions, people offered to help me carry my gear. I work in the fly car so I am often on scene first, and then I turn the call over to the responding crew if they are ALS or if they are…