Please don’t let me slip and fall — I am already halfway across — please I do not wish to plummet to my icy death or to land on the jagged rocks at the river’s edge. If the bridge is to give out, let it break first at the far side and go one board at a time like in the cartoons and let me run fast, one board ahead of disaster. Please no Wyle Coyote falls for me.
Category: ems-topics
My Hollywood Adventure
In 2006, I was asked to be a advisor/possible writer on the TNT show SAVED when the show was green-lighted for 13 episodes. Unfortunately, the money they offered me was less than I was making in 40 hours much less the 80 hours I was working. Had I been younger and less attached, I likely…
Second District
It is interesting seeing the streets you spent so many years working on the subject of film. Hartford is a small city, but like its sister cities New Haven and Bridgeport, it has always had one of the highest murder and poverty rates in the nation.
Called In Sick
If I feel like death, like I will never be well again, but I am well hydrated and my pulse is only 72, and my sat is 99%, and my fever barely a 100, what must it feel like to be really sick?
The Years
If I ever had a call – a double shooting or a status seizure — where I could look back and say here is where it all came together, then I have forgotten it. What I remember from my earlier years as a medic is not so much one specific call, but rather gradual realizations…
Cold Justice
Australian author and former paramedic Katherine Howell has written her third EMS-related crime thriller, Cold Justice. Like her first two thrillers, Frantic and the Darkest Hour, it is a great read. The books have a constant character in police detective Ella Marconi, who teams with a different paramedic in each book to solve the crime….
Paramedic Awareness
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.
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…
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?
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.