I wrote this a couple months ago when I was feeling really burned out. The burnout passed, as I knew it would, and I am back to myself, so I can post it now. (1) I have been responding to 911 calls for twenty-six years, 21 as a full time paramedic with a busy urban commercial…
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EMS Opiates and Chronic Pain – 2
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…
EMS Memoirs/EMS Fiction
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…
Footprints
Three sets of footprints in the snow. Two with fully defined treads. Mine barely register. I’m twelve years older than the two of my partners combined. This is my fifth pair of boots and the soles have gone smooth. I walk carefully. We do a call and I can’t make it up the icy driveway….
Same Old Song and Dance
When couples get old, they communicate with fewer words or sometimes just a look. I am feeling that way about my EMS reports at the ED. Where I used to rattle off every detail I could think of (from brand of cereal they had for breakfast to the number and locations of the moles they had…
In Defense of ALS
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:…
Changes
People are always asking me what changes I have seen over the years. Here are four changes I have been thinking about lately. More paramedics. When I started we had anywhere from two to six paramedics on to cover the entire city of Hartford and backup the other three large towns we covered. On many…
The Finger
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…
Assembly Line
Many years ago, I worked on assembly lines in factories. I put together and or packaged everything from Christmas Tree stands and door knobs to fast food store deli sandwiches and grocery store beef ribs. The key to the assembly line was to go a little bit faster than you were comfortable going. You had…
Lights and Sirens
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…
Intranasal Narcan for All
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…
The Mentor (or what they remember)
I am working with a young man who I have mentored since his first day as a volunteer at my old suburban post. I have tried to teach him the right way to do the job – to be thorough, to be considerate, to be empathetic, to be professional. We have done many calls together…
The Butler Did it
There are any number of different ways to give a verbal handover report at the ED. All sorts of mnemonics. What form you use may depend on what your hospital expects. I try to tell a story. But I don’t tell a story in the same way I would write one. A written story takes…
Practice
A comment and discussion on my previous post sparked me to revisit a post I wrote 9 years ago about the issue of working a body for the practice. Practice Here’s what I wrote back then: My preceptee needs a code. He probably needs a couple. He hasn’t done one as a medic yet. He’s…
Vision
When I was 12 years old, I was a good baseball player. I loved the game and had great hand-eye coordination. I was a contact hitter and a slick fielder. In the regional Little League tournament, I made a diving backhanded catch of a line drive at 3rd base that people talked about for years….
Thoughts on Ebola
Working at the hospital and on the ambulance, it has been heavy duty Ebola lately. Memos, flyers, posters, policies, and lots of questions. I have written power points, given talks and had many conversations on Ebola. Every day I read the CDC site for updates, which are numerous. I have even, along with two of…
Breaker of Men
We find our patient by the elevator doors in a public building. He is on all fours, dry heaving, and shaking. He says he is in terrible pain. Security tells us he is a visitor to this public building. They don’t know anything about him other than that he has been screaming that he is…
Streamline
This is the first I have written since May. I did not mean to stop writing. I had many thoughts, but just never got around to putting them down. Why no posts? A variety of reasons, primarily time. As I get older I find myself less sure of myself and my ideas. I can spout…
Whup Kits and Chihuahas
Many of us in EMS love gadgets I remember when I started another EMT sold me a “whup kit,” which was a holster that attached to my belt to hold my tools. I didn’t get a big one, just a modest sized one. It held a pen light, trauma shears, bandage scissors, tweezers, and a…
Connecticut to Allow BLS/First Responder IN Narcan
Yesterday the Connecticut Emergency Medical Services Medical Advisory Committee reversed its position from a year ago and voted to approve Intranasal Narcan as a sponsor hospital option for first responders and BLS services in the state. This does not mean that all first responders and BLS responders will be giving Narcan. It only means that…