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…
“He cut them down in droves–the corpse fires burned on, night and day, no end in sight.” – The Illiad -Homer (Robert Fagles translation). In 2017, for a powerpoint presentation on the opioid epidemic, I made a slide that showed a graph of annual nationwide fatal ODs (about 15,000) from when I started as a…
“You’re covering the city,” dispatch says to us, when we clear Saint Francis after an early morning cardiac arrest. We park on Albany Avenue. The sun isn’t up yet, but the black birds are stirring. We’re on for another ten hours. By midday, we’ll have twenty ambulances on, but right now it is only us. …
(This is an excerpt from a fictional work-in-progress.) Frank Anastacio walked out of the brick building with a small paper bag in his hand. His work boots trudged forward, each step taking him deeper into a world he no longer wanted to live in. The autopsy report said she had died of asphyxia from tying…
When I started as a paramedic in Hartford, many of my coworkers referred to the city as a shit hole. They said this as they put on or took off their bullet proof vests at our base and swapped stories about the populace they encountered in the inner city, drunks and deadbeats, and addicts and…
This week I have been reading/listening to Sam Quinones new book “The Least of Us” about the changes in the opioid epidemic caused by the shift from heroin to fentanyl and the shift from ephedrine-based methamphetamine to a more dangerous type he calls P2P meth. A federal drug agent told me a few years ago…
This week I was asked by the Connecticut Alcohol Drug Policy Treatment SubCommittee to comment on the new FDA approved high dose 8 mg naloxone product, Kloxxado, from the EMS perspective, Here’s what I told them: Three Points High dose naloxone has no place in EMS/First Responder arsenal. 2. It has not been proven…
Thirty three years I’ve been in EMS now and if there is one line of advice I have for people starting out in the field, or just for life in general for that matter it is: Don’t Be an Asshole EMS is stressful and we are constantly in situations that may put us in conflict…
(An excerpt from a fictional work in progress.) Prologue Hernando already had a 200-gram bag of heroin on the table, as well as a smaller baggie of fentanyl, a canister of baby formula, four packages of Benadryl, and several small open cardboard boxes, each holding 600 of the blank glassine envelopes they would be putting…
A firefighter has already bandaged the patient’s head by the time I arrive in the fly car. The man sits on the front stoop looking like the fifer in the revolutionary war painting of the three marching wounded soldiers the way his head is wrapped. The firefighter points out the puddle of blood in the…
When I started as a paramedic in Hartford in 1995, I thought drug users had character flaws and belonged in jail. Last week at a panel discussion in Hartford I stood up before National Drug Control Policy Acting Director Regina LaBelle, United States Senator Richard Blumenthal, United States Representative John Larsen, and the Mayor of…
She took the Dilaudid pill a friend offered her twelve years ago when she was sixteen. Her sister had recently died and her young life, filled with depression and anxiety, had lost its only source of light. The pill made her feel well in a way she had never felt before. She liked who she…
I am sixty-three years old, six foot eight. I used to be six nine and a half, but life has beaten me down. Over thirty years in EMS has flattened my spine to the point that some days I can barely feel my legs. I have no business being back on a basketball court, but…
“Dopesick” is a new eight-episode series dramatizing the start of the opioid overdose epidemic that originated with Purdue Pharma’s marketing campaign for oxycodone .The series is populated with a fictional cast of characters, including a country doctor (Michael Keaton), a young woman injured in a coal mining accident and her parents who struggle to understand…
For many of us in EMS, our origin story began with watching the TV show Emergency. The decent paramedics Johnny and Roy, the wise Drs. Brackett and Early, and the beautiful unflappable nurse, Dixie McCall. Together they stood for all that was good in the world. They were role models for us in showing us…
Xylazine, a horse tranquilizer, has been increasingly found as an adulterant in the East Coast street supply of fentanyl. In 2019 in Connecticut, xylazine and fentanyl were found together in 71 overdose deaths. There were 141 deaths of this combination in 2020, and in 2021, through August with still many cases outstanding, the number…