You are on scene of an overdose. You have just resuscitated a man who was apneic and now admits to snorting heroin he was given by a friend. He just got out of jail and hadn’t used for over two years. You explain both the danger of the fentanyl that is on the street in…
Someone you care about is graduating from paramedic school. What is the best gift you buy them? Only two choices in this exercise. 1. A high quality stethoscope with their name etched on it. 2. A good pair of boots. When I graduated from paramedic school, I bought myself a Littmann cardiology 2. It was…
When my book Killing Season came out, Amazon chose it as one of the best nonfiction books of April 2021. The book was also profiled on CSPAN books and I was interviewed by major networks including the BBC and ABC. I was hoping for a review in the New York Times Book Review, but no…
I want to make it to 72. I want to be a 72-year old paramedic. I would like to live much longer of course. 84 sounds good. Or older would be even better as long (as I am reasonably healthy), but I want to be working as a paramedic at 72, even if I am…
From July to November 2021, the Connecticut Poison Control Center (CPCC) received 39 reports from emergency medical service (EMS) responders of overdose patients with opioid toxidrome syndrome (depressed consciousness, apnea or agonal breathing and pinpoint pupils) who EMS resuscitated with naloxone, but who afterwards stated they only used marijuana and denied opioid use. Three of…
As many are aware, recently in Hartford there was a tragic fentanyl overdose at a Hartford middle/secondary school that resulted in the death of a 13-year old and two other 13-year-olds being transported to the hospital after being “exposed” to fentanyl (Police: Teen who overdosed on fentanyl at Hartford school has died). The news reports…
Several years ago I sat in a meeting of an overdose committee and listened to a woman argue that we should have naloxone in all the middle schools. I am a data person and I pointed out that middle schools are not where people are overdosing. If you only have a limited amount of resources,…
They say the omicron wave is past its peak here in Connecticut. The infection rate is declining as are dailey cases. Even wastewater measurements seem to say the wave is receding. While we didn’t have the deaths we saw with the first wave (thank you vaccines), our hospital had record numbers of admitted hospitalized patients…
This past week in Hartford, a 13-year old boy brought some bags of fentanyl to school. He later collapsed and received CPR from a school teacher. EMS arrived and resuscitated the child, who died two days later in the hospital. Bags of fentanyl were recovered from the scene and the boy tested positive for fentanyl. …
The patient has a fever, headache and cough. He can’t smell anything and he can’t taste his food. He feels too short of breath to even get out of his chair. He sits there with his hand over his eyes as if not seeing might make how sick he feels go away. His sister says…
I’m recerting PALS (Pediatric Advanced Life Support), ACLS (Advanced Life Support) and CPR today in one all-day session. After this, I’ll be good for another two years. If you are in EMS, you can measure your career by how many American Heart Association recerts you have taken. For me this is the 15th time for…
Our ED has seen record volumes of patients in recent weeks, many with COVID. Most of these COVID positive patients recently tested positive, and not feeling well with minor shortness of breath fever or body aches, come to the ED where they are evaluated and sent home. Our in hospital COVID admissions are only 50%…
Overdose on the avenue — a woman in a tattered hoodie and black winter coat lays on the sidewalk next to a streetlight, with bystanders surrounding her. The woman, who looks to be in her forties, was talking to them and then she slowly collapsed against the pole and then to the ground. If I…
I try to time my calls so that I have everything done that I need to have done by the time the ambulance backs into the hospital ED bay. I know some medics are taught to do everything on scene. If a patient is sick and needs immediate care, I will absolutely treat them on…
An old man sits on a bench in front of the police substation in one of the worst areas of town. When he sees the narcotics sergeant, he says, “How goes the War on Drugs?” The sergeant says, “Great. We put twenty dealers away this week. Sent them all to prison.” The old man sees…
For the last year I have worked primarily in a rapid response vehicle or “fly car.” There are many benefits to such a position. I do almost exclusively 911 calls. I self dispatch based on calls I hear over the fire and EMS radios. I am often the first on scene. My day is never…
Through my plastic face shield, fogged up by my N95, my too small gown tied around my waist and neck, I stand at the foot of the bed and look at the man. He is sixty years old, eyes fearful, face flushed with fever, his hands tremble with rigors. He mumbles, “What took you so…
I was walking in Pope Park, my EMS radio on my belt, and the ambulance idling not a minute away, I stopped by the pond where there is a open air building with a concrete floor where users often sit against the walls and shoot up, out of site of traffic. I go down there…
A recent article in JEMS argued for an EMS system model, heavy on BLS with just a few experienced medics, similar to the model used in Boston. The article revolved around an anecdote where two experienced BLS providers helped save a man with a ruptured appendix, by transporting him rapidly to the hospital. The article…
There are three loaves of bread sticking out of a paper bag in the passenger seat of the car. I recognized them from the bakery on Park Street where people pick up fresh long loaves of the crusty pan de agua (water) bread hot out of the ovens when the shop opens at six. It…