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…
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…
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…
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…
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…
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…
I have been injured seriously enough to miss work twice in the last two decades. Neither time was I injured on the job. The first injury was playing softball on our ambulance team (back when we had one). I went from first to third on a single, and as the third base coach signaled me to…
One of the greatest shames in EMS is that we so often never find out what the real deal was with our patients. 17 year old boy whose parents swear he never does drugs (but did go to a concert last night) is found in his room the next day talking gibberish, reaching for objects…
Kevin Grange’s new memoir is now out. Lights and Sirens is an authentic, compelling narrative of Grange’s journey through UCLA paramedic school and field internship on Los Angeles’s dangerous streets as he trains to save the lives of victims of heart attack, stroke and trauma. Grange is an excellent writer who does a great service…
In the late 1970s and 1980s, the G——Motor Lodge out on the Turnpike was the place to take your girl for a swinging good time. Mirrored ceilings and heart shaped Love-Tubs. The brochure featured a hairy-chested mustachioed man in a velvet bathroom holding a bottle of champagne in one hand and a filled glass of…
I was on Park Street last week headed into El Mercado to get some pernil (roast pork), yucca and tostones for lunch when a gentleman came up to me and showed me his overdose kit. He said he’d gotten it at the local needle exchange program. He said he had already used it once when one…
One of the best innovations in EMS in recent years has been the introduction of intranasal medication through the use of an atomizer. We currently carry three drugs that we can use intranasally. These are Narcan, Fentanyl and Versed. After several years of experience now with all of these drugs through the intranasal route, here…
On October 15, the new American Heart Association Guidelines for CPR and ECG will be published. Then we will get the answers to the big questions many of us have wondered about? 1. Has epinephrine in cardiac arrest seen its last days? 2. Should paramedics continue to intubate cardiac arrest patients? 3. Will traditional CPR…
This past week I had the pleasure of reading an advance copy of a new paramedic memoir. Kevin Grange’s Lights and Sirens is an authentic, compelling narrative of Grange’s journey through UCLA paramedic school and field internship on Los Angeles’s dangerous streets as he trains to save the lives of victims of heart attack, stroke…