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…
Calm
When I first became an EMT, a friend asked me why I liked the job so much. When I come through the door, people look at me like I am an angel, I said. What is it like driving lights and sirens? Another friend asked. Awesome — I feel all powerful. I hit wail and…
Two Boys
We are called for an unconscious and find the man out cold on his feet near Pope Park. He is a tall man in his early thirties with a ghost white complexion, standing there on the side of the road, his head nodded forward, arms hanging down swaying. Another drug user on the nod in…
Austin Eubanks
I attend the Department of Public Health’s 2019 Connecticut Opioid & Prescription Drug Overdose Prevention Conference on May 2. The featured speaker is Austin Eubanks, a survivor of the Columbine shooting. He and his best friend were golfing and fishing buddies. He shows us pictures of the two of them smiling, no idea what fates…
All
I’m on scene of an overdose. A fifty year old man in an unkempt apartment went unresponsive after sniffing two bags of heroin. His neighbor found him, giving him 4 mgs of Naloxone IN, and then called us. The man is alert and oriented by our arrival and does not wish to go to the…
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…
Muscle Rigidity in Opioid Overdose
I wrote a number of months ago about fentanyl induced chest wall rigidity in opioid overdoses. Chest Wall Rigidity Fentanyl induced chest wall rigidity is rare in the hospital setting, but it should not be surprising to find it is a factor in overdose outside the hospital given that the amounts of fentanyl being injected…
Dancer
I first picked Veronica up on Hungerford Street one afternoon two years ago. We had been called for an unresponsive, but instead, we found a small woman with a club foot staggering along the street. She was half on the nod and covered with leaves. I asked her if she was okay, as we walked…
Manual Versus machine Blood Pressures
How do you want to be known as a Paramedic/EMT? A. Reliable B. Frequently wrong According to a recent article in JEMS, Ditch the Machine to Improve Accuracy in Blood Pressure Measurement and Diagnostics, “automated blood pressure readings are frequently inaccurate.” Is this a surprise to anyone? Yet, many of us continue to relay on automated…
Balance
December 8, 2018: This weekend, I am in Worcester, Massachusetts at the New England Short Course Meters Masters Swimming Championships as a member of the Connecticut (CONN) team. Last year, we shocked many of the other teams by taking first place. Points are awarded based on place finish in individual and relay events. Each swimmer…
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…
Chains
We’re sent to the courthouse where a marshal takes us back to a holding cell. A thin, bearded man with cuffs around his wrists and his legs chained is bent over in the bare cell, grimacing. “Guess he got nervous about seeing the judge,” the marshal says to us, “Developed himself some back pain.” “I’ve…
Unforgiven
He is walking down a side street off Park when he freezes in place. He sees the slow moving black Toyota blink its lights, then he sees the station wagon. Before he can take a step to flee, he sees the barrel come out of the back window. He feels the impact against his shin…
Obituary
I see Maria outside the Spanish market, squatting against the building. She is a tiny woman in her fifties who was introduced to heroin thirty years ago when she was living in New York. The father of her son used it occasionally and when he used, she was obligated to sniff some as well. It…
A Walk in the Park
A walk in the park to stretch the legs while on post. The medic walks past a row of port o-potties from a weekend event. One port-o-potty is not fully closed. A sneaker blocks the door door. On second glance the sneaker is attached to a foot. Open the door and an unresponsive man tumbles…
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…
Safe Injection Sites
I wrote an op-ed this month that was published by the Hartford Courant. Insight: I See What Heroin Does. Let People Shoot Up Safely Included was a checklist: 5 Things to Know About Heroin Addiction I read an article a few days later that said that when called an “overdose prevention site,” as opposed to…
Epinephrine in Cardiac Arrest
The use of epinephrine in prehospital cardiac arrest showed no difference versus placebo in determining favorable neurological outcome according to a long awaited randomized controlled study published yesterday (July 18, 2018) in the New England Medical Journal. The trial showed epinephrine produced a higher rate of survival at 30 days than placebo, but that was…
Veins
Kelly is as dispirited as I have seen her. “My veins are shot,” she says. “I can’t even get high.” IV users use 1 cc syringes which have a very small needle they only need to slip inside the vein. When they pull back and get blood they know they are in. They push the…