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Chains

Written by RSS Poster Medic Scribe on the 20th October 2018 at 16:01 - Posted in Ambulance Blogs

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 had back pain all day,” the man says. “And I’m not ducking anything. I’m in here for panhandling for Christ sakes! I can’t fucking sit up.” “You didn’t tell that to the
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Obituary

Written by RSS Poster Medic Scribe on the 19th October 2018 at 3:05 - Posted in Ambulance Blogs

I had three people tell me to read this obituary a woman wrote about her sister who died at thirty-two after a long struggle with addiction. Madelyn Linsenmeir, 1988-2018 Powerful.   While I am most moved by the first part that describes Madelyn and shows the clear love of her family for her, I am excerpting the end below because it contains a message for us as health care professionals. If you yourself are struggling from addiction, know that every breath is a fresh start. Know that hundreds
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Spare Change

Written by RSS Poster Medic Scribe on the 09th October 2018 at 11:53 - Posted in Ambulance Blogs

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 didn’t take her long to get addicted. She has grandkids, but she never sees them. Her father is still alive, but even though she misses him terribly, she doesn’t want him to see what she has become. She says
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Supraglottic Versus ET

Written by RSS Poster Medic Scribe on the 06th October 2018 at 15:06 - Posted in Ambulance Blogs

“EMS personnel and physicians involved with protocol development for EMS systems in the United States, United Kingdom, and similar settings with limited exposure to advanced airway management should reconsider the routine use of endotracheal intubation as the first-line strategy for airway management in out-of-hospital cardiac arrest.” This is the conclusion of an editorial in the August 28, 2018 edition of the Journal of the American Medical Association. The editorial, “Pragmatic Airway Management
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Connecticut Overdose Death Numbers

Written by RSS Poster Medic Scribe on the 14th September 2018 at 13:24 - Posted in Ambulance Blogs

The opioid overdose epidemic continues to rage in Connecticut, although numbers again show the carnage may be plateauing. The Connecticut Medical Examiner’s Office just released the overdose death numbers for the first six months of 2018. Connecticut Medical Examiner’s Statistics  515 people died in contrast to 500 and 538 in the two previous six month periods. The numbers continue to show the rise of fentanyl as the cause behind the overdose deaths, Source: Ct. Medical Examiner’s
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A Walk in the Park

Written by RSS Poster Medic Scribe on the 10th September 2018 at 9:02 - Posted in Ambulance Blogs

  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 out. A syringe and empty heroin bags lay on the ground. The man is blue and breathes only on stimulation. One shake, one breath. The medic radios his partner who drives the ambulance across the sidewalk
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The Opioid Chapters

Written by RSS Poster Medic Scribe on the 08th September 2018 at 16:44 - Posted in Ambulance Blogs

Check out this web site to read about eleven people affected by the opioid crisis, including a paramedic who injured his back on the job. The Opioid Chapters

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Water

Written by RSS Poster Medic Scribe on the 08th September 2018 at 14:28 - Posted in Ambulance Blogs

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 water is so they don’t throw up and aspirate while the anesthesiologist is trying to intubate them at the start of surgery. This all comes from two cases in the 1950’s where pregnant woman aspirated during
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Fentanyl: The Real Deal

Written by RSS Poster Medic Scribe on the 06th September 2018 at 11:39 - Posted in Ambulance Blogs

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 symptoms no worse than lightheadedness and tingling hands.   I have
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Safe Injection Sites

Written by RSS Poster Medic Scribe on the 17th August 2018 at 19:22 - Posted in Ambulance Blogs

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 a “safe injection site” people were much more likely to support the concept. Support increases when opioid ‘safe consumption sites’ called ‘overdose prevention
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Epinephrine in Cardiac Arrest

Written by RSS Poster Medic Scribe on the 19th July 2018 at 13:15 - Posted in Ambulance Blogs

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 accompanied by almost twice the rate of severe neurological impairment. Over 8,000 patients were enrolled in the randomized double-blind
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Veins

Written by RSS Poster Medic Scribe on the 05th July 2018 at 15:45 - Posted in Ambulance Blogs

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 plunger slowly, sending the heroin directly into their vein and right into their circulation where quickly delivers its powerful payload to the brain. This is a faster and stronger route than swallowing a pill or inhaling
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Pulmonary Edema in Opioid Overdose

Written by RSS Poster Medic Scribe on the 23rd June 2018 at 14:06 - Posted in Ambulance Blogs

She finds him in the bathroom at seven in the morning and knows immediately he is using heroin again. Three weeks ago, they moved east from Seattle. She had a job offer and it also represented a chance to get him away from his junky friends. After three times in rehab, she didn’t think she could go through it with him again so she was thrilled when he agreed to move with her. They got a nice loft downtown, with plenty of light. It was close to her job, and from across the street, he could get
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Slipping Out

Written by RSS Poster Medic Scribe on the 21st May 2018 at 1:27 - Posted in Ambulance Blogs

The man is trembling, sitting on the bed in the spare motel room down by the highway. Sometimes, these rooms are filled with the patient’s worldly belongings, but this room seems to only have the bed, a dresser, a chair and the TV. The man is in his fifties, a portly man with white hair and liver spots on his hands. The Spanish woman in the room with him is of an indeterminate age. She wears a pink tank top and grey yoga pants with flip flops, even though it is cold and blustery out. She is the
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Diploma

Written by RSS Poster Medic Scribe on the 06th May 2018 at 1:20 - Posted in Ambulance Blogs

The man is on the nod, the only thing keeping him up is the fence he is leaning against. When the police officer tries to extricate him from the fence, he falls back and the officer has to lower him to the ground. I set my red bag down to get out my ambu-bag, but I can see the man is still breathing regularly. I shake his shoulder. He opens his eyes. No need to get out the Naloxone. I lift him up under his arms, while my partner grabs his legs. We get him on the stretcher. He nods back out. We find
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