Two tattooed muscle head dudes in their twenties, one a convicted felon, who used to work construction as well as sell steroids, started a small business in which they hired a doctor to write prescriptions for pain medicine to most anyone who came through the clinic’s doors during business hours. The doctors got $75 a…
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…
Check out this NPR radio podcast: Do You Think Your Heart is Healthy? I was fortunate enough to be asked to be one of three guests on the Colin McEnroe Show this week. I was on to talk about what people can do during a cardiac emergency from a paramedic’s perspective. Thanks to Colin and…
Should paramedics give opiates to patients with chronic pain? I want the answer to this question. Now, until recently I have not questioned this practice. Today, I still medicate (well, most*) patients with chronic pain of 4 or more, who do not have contraindications, and who say yes when I ask them if they want…
The heroin epidemic is getting a lot of play in Connecticut. In 2015, according to the latest numbers there were 415 heroin deaths in the state, triple the number three years ago. There is a bill in the legislature to require all first responding agencies in the state to carry naloxone. Here’s a news article…
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…
If you have access to HBO, you should watch their new documentary Heroin: Cape Cod, USA. It is also an excellent companion to the book Dreamland: The True Tale of America’s Opiate Epidemic, which details the rise of pain pill addiction and the resulting shift over to heroin among the pill abusers. The documentary follows…
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….
In my standard talk urging paramedics to be generous with pain management, I have a section called pain myths. One of the myths is entitled Fear of Creating Addicts On the powerpoint I have two pictures, one of an all-American housewife, the other of a skanky drug-addled prostitute. Here is the text from the slide:…
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…
I once did 10 cardiac arrests in one day. They were all v-fib arrests. I managed each code from the moment I arrived to find CPR in progress to the moment the patients were whisked off to the cardiac cath lab. I got 10 successful ET tubes, and despite the studies that show ET intubation…
A few days ago on our employees only Facebook page, someone posted a picture another person had taken of one of our crews while they were parked by the side of a street. The driver leaned against the window, arms folded, eyes closed. The passenger had his eyes open, but he was slouched down in…
On Sports Radio this morning they were talking about the decline of three sports legends – Tiger Woods, Peyton Manning and Kobe Bryant. The radio host, a retired athlete himself, was saying how no one who hadn’t played professional sports could possibly understand what these three were going through. He said they dedicated their lives…
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:…
The long wait is over. The AHA 2015 CPR and ECC guidelines are finally here. For the first time in many cycles, there are few changes. No, you will not have to relearn CPR, and your drug kits will not see an overhaul. The guidelines finally offer a lukewarm acceptance (“it may be reasonable”) to…
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…
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…
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…
One of the greatest shames in EMS is that we so often never find out what the real deal was with our patients. 17 year old boy whose parents swear he never does drugs (but did go to a concert last night) is found in his room the next day talking gibberish, reaching for objects…
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…