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.
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…
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…
When I see murals in the city, it makes me feel love and joy for life and the people of Hartford. And these Below, gone, but not forgotten.
I received a book in the mail about a month ago. I slipped it into my briefcase to read while in between calls in the rapid response vehicle in Hartford. It sat there in its unopened package for weeks as I was too busy between calls and writing PCRs to take it out. Yesterday, Saturday,…
“You need to get that checked out,” I said. “I’m not going to the hospital. They treat me like shit there.” “I’m sorry they do, but that’s not getting better.” The woman has a nasty necrotic ulceration in her AC that has eaten away the skin and some of the tissue underneath. It is black…
A young EMT saw me at the hospital this week as we were both bringing patients in. She had a present for me, she said. After I got my patient situated in their assigned bed in the hallway and gave a report to the nurse, I went back outside and met the EMT. She reached…
In EMS, we are eyewitnesses to the inevitable decline of the human body and to death. That’s why when a young person dies it shakes us deeply. They are not supposed to die. It is hard to disassociate yourself from such an event. On those rare occasions that my Pandora’s box of bad EMS memories…
When I first started in EMS I was almost always the first on scene because our local fire department only responded to jaws of life calls and the PD usually only responded to reports of violence assaults. I loved getting their first. The scene was pristine. Sure I had a dispatch subject, but from early on…
Someone you care about is graduating from paramedic school. What is the best gift you buy them? Only two choices in this exercise. 1. A high quality stethoscope with their name etched on it. 2. A good pair of boots. When I graduated from paramedic school, I bought myself a Littmann cardiology 2. It was…
I was walking in Pope Park, my EMS radio on my belt, and the ambulance idling not a minute away, I stopped by the pond where there is a open air building with a concrete floor where users often sit against the walls and shoot up, out of site of traffic. I go down there…
A recent article in JEMS argued for an EMS system model, heavy on BLS with just a few experienced medics, similar to the model used in Boston. The article revolved around an anecdote where two experienced BLS providers helped save a man with a ruptured appendix, by transporting him rapidly to the hospital. The article…
This week I was asked by the Connecticut Alcohol Drug Policy Treatment SubCommittee to comment on the new FDA approved high dose 8 mg naloxone product, Kloxxado, from the EMS perspective, Here’s what I told them: Three Points High dose naloxone has no place in EMS/First Responder arsenal. 2. It has not been proven…
No one ever said being a medic was easy. Do the best you can. Know your protocols. Use sedation with caution. Act on your patient’s behalf.
I am pleased to announce the relaunch of my blog on a new server. I began this blog almost 20 years ago on the blogger network. Quite a number of years ago, I was recruited to move my blog over to an EMS network, which I did in hopes it would increase my viewership. They…
I just watched a fantastic and very thoughtful lecture of pediatric cardiac arrest given by Dr. Peter Antevy as part of the Refresh2021 free national registry program, which I encourage everyone in EMS to sign up for. Register for Refresh 2021 When I precepted as a paramedic in 1995, my preceptor told me when we had a…
In Connecticut, when EMS responds to an opioid overdose, after they have taken the patient to the hospital, accepted a refusal, or presumed a patient dead, they are required to contact the state poison control center and answer a series of questions about the overdose. The program, known as SWORD (Statewide Opioid Reporting Directive), that…
We are told to keep six feet of distance from each other, but how effective is this the distance in preventing the spread of COVID-19? The answer may well be, yes, it helps, but it is not the full answer. In a new article published in the British medical Journal provides a fuller view of…
For over twenty-five years I was a full time street medic. I have been part-time now for only a few months. I have tried to work at least 20 hours a week, but there have been a couple of weeks when I have only worked once, and one week where I did not work at…