The next drug to add to the EMS formulary should be water. That’s right. H20. How many times have you been on a call and the patient has asked for water only to be told by every EMS responder in the room, “No! You can’t drink anything!” Really? The reason we don’t let people drink…
Category: Uncategorized
How We Feel Versus What Dispatch Hears
It has been busy at work lately and the crews have been getting pounded. An EMT posted this video (found on the internet) on our employee Facebook page. I laugh every time I think of it. If you have never worked commercial EMS in a high volume system, you might not appreciate it. I can…
Connecticut Overdose Deaths 2018
The official death numbers for 2018 are out from the Connecticut Medical Examiner’s office. Connecticut Accidental Drug Intoxication Deaths 1017 people died in Connecticut of accidental overdoses, down 21 from 2017. This is the first decline (albeit minor) after six years of escalation. 746 people died in Connecticut due to the presence of Fentanyl, up…
Cocaine with Fentanyl
When they can’t get a hold of their local dealer, the two young men come in to Hartford from the suburbs to buy cocaine. Bart boasted to a younger friend Milton that he could get any drug he wanted on Park Street. “Well, let’s do it,” Milton said. It is true that Bart knows where…
Fentanyl: The Real Deal
Misinformation and inconsistent recommendations regarding fentanyl have resulted in confusion in the first responder community. – Fentanyl Safety Recommendations for First Responders (Revised) from the Office of National Drug Control Policy. It seems every week responders are getting exposed to Fentanyl, being rushed to the hospital, with many getting Narcan, all often without exhibiting any symptoms or…
Hartford Opioid Crisis Interview
One of my EMS coworkers and a budding journalist Sean Freiman interviewed me recently about Hartford’s Opioid Crisis with a focus on the heroin bags. Click on the picture to view the interview.
Katrina Journal
In view of Hurricane Harvey and the rescue efforts now underway, I am posting notes from my journal when I was posted in Gulfport, Mississippi in the aftermath of Hurricane Katrina. Day One: Waiting On the morning of September 17, we meet at the office and a chair van driver takes us up to the…
Bart Simpson Does Heroin
Bart Simpson is in his parent’s Subaru parked to the side of a gas station in Hartford, Ct near the highway ramps. The car is running, in drive, his foot is on the brake. He is slumped forward against the wheel. This has aroused the attention of passerbys who have called 911. An ambulance arrives…
Murals of Hartford
I have been writing much lately about sorrow and despair in Hartford, so I thought I would take a break, and lifting my eyes up from the heroin bags on the ground, look at some of the beauty of Hartford as seen on the city’s murals.
The Wolf and the Sheepdog
In the Looney tunes cartoon, Ralf E. Wolf and Sam the Sheepdog go to work each morning, exchanging greetings while punching the clock. “Morning, Ralph,” the dog says. “Morning, Sam,” the wolf replies. Then it is down to business. The wolf spends his hours trying to steal the sheep and the sheepdog spends his hours…
Burnout (with Footnotes)
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…
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…