When Fentanyl arrives in my kit, it will likely be ranked quite high on my list and push Toradol down even further, possibly to the point where we will have no need to carry it.
Activated Charcoal
I must confess that in my 21 years riding ambulances, 18 as a paramedic, I have never given Activated Charcoal to a patient.
Vasopressin
“In summary, the use of vasopressin alone or in combination with epinephrine as the first line vasopressors during resuscitation from cardiac arrest offers no benefit related to short- and long-term survival compared to the use of epinephrine alone.”
Upstairs
The asphalt is white with salt. What grass pokes out from the crusted snow is a dull yellow. The houses in this lower middle class neighborhood are all grey. Walking up to house, I am struck by the only color I have seen for days. On a concrete slab of a driveway there is a…
Dueling Coughs
“You sound worse than I do,” my patient said to me this morning. “How about we draw straws to see who gets seen at the ED first,” I said. My cough is actually improved from a week ago. My preceptee was treating a lady with chest pain who had a deep rattling cough. I was…
Glimpse of the End
Let me say right from the outset that I love being a paramedic and dread that day that I can no longer do this work. That said I have had two moments in my career where I have glimpsed that day. These moments are not moments that you would expect. It was not a bloody,…
Where Am I?
It’s a great feeling to wake slowly and wonder where I am and slowly open my eyes and realize my surroundings. “Hey, I’m already at work. How great is this!”
Death By Detergent
A hundred yards ahead, we can see the officer standing by the snow-covered car, but then he turns and waves his arms to get our attention. “Stay there!” he shouts.
The Bedpan
Somewhere Around Here I have to confess in my twenty-one years in EMS, I have only gotten the bed pan out less than a dozen times. I also admit there were occasions when the bed pan was not always in the first place in the ambulance I looked (this was at a time when I…
Interview
I did an interview with Greg Friese of Everyday EMS Tips as part of his EMS Author Chat series.
No Easy Trail
Police cordon off the abandoned vehicle with yellow tape. It is an 86 Plymouth – an old man’s car. “Am I going to need all my gear, or just the monitor?” I ask the officer. “The monitor.” I look across the grass toward the tree line at the eastern end of the cemetery. I don’t…
Ambassador of Love
In emergency medicine, field and hospital come together when the EMT/paramedic hands over patient care to the nurse. This transfer is almost always professional and courteous. The good feelings demonstrated on the job between paramedic and nurse are not limited to working hours. After we punch out for the shift, we often meet in restaurants,…
Running the Streets
I finished my half marathon on Saturday, limping across the finish line in 2:34:14. Part of the run went through streets and neighborhoods in Hartford where I have responded over the years to motor vehicles, drunks, cardiacs, asthmas, shootings, diabetics and general illness. When I started as a paramedic in Hartford, I did most of…
Flu Shot
Flu season is rapidly upon us. I woke up this morning with a slight case of the sniffles that as the day has gone on has proved to be (hopefully) somewhat of a false alarm. I am hoping to get through the week unaffected as next Saturday I hope to run* in my first half-marathon….
The Golden Hour
R. Adams Cowley, the founder of Maryland’s well-known Shock Trauma hospital in downtown Baltimore, famously said: “There is a golden hour between life and death. If you are critically injured you have less than 60 minutes to survive. You might not die right then; it may be three days or two weeks later — but…
Trauma
Tonight is the premiere of another new EMS oriented TV series — Trauma — which is on at 9:00 PM EST on NBC. At that hour I will likely be reading “Brown Bear, Brown Bear What do you See?” and “Good Night, Moon” to my twenty-month-old daughter in hopes that she will finally close her…
Elmo’s Song
I’ve written recently above the new advances that have made our care and lives easier: Stretchers going from two man to one man to now power-operated. Airway adjuncts like bougies, LMAs, and of course capnography. Life Pack 5s to Life Pack 10s to LifePack 12 with 12-leads. EZ-IOs. I discovered another one just the other…
Incredibly Nimble
We were sent today for a lady too dizzy to get out of bed. There were elaborate instructions given about where the key was in the garage. We searched for about fifteen minutes with no luck. It was dark in there and dusty and there were mouse traps everywhere. We saw two neighbors come over…
Learn Something Every Day
50-year-old woman recent heart surgery to replace a valve. Visiting nurse says the patient is bradycardic. The officer tells me the patient doesn’t look very good. I find the woman laying on the couch with a nonrebreather on. She says she doesn’t have any pain, but doesn’t feel well, and vomited a couple hours ago….
Work
I came into work yesterday morning and as I always do, switched ambulances. We have three rigs here, and each of the four regular medics are assigned their own (two share one). Every six months or so we switch assignments. Right now I have my own ambulance, but it is the oldest one. Very rough…