Why You Should Go to an EMS Conference

You should attend an EMS conference at least once in your career. My first exposure to an EMS conference was Connecticut’s state conference. I had only been an EMT a few years – my influences were limited to my excellent EMT instructor, and the great people I worked with at Eastern Ambulance, a small five […]

In Defense of ALS

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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: […]

New England Paramedic Treatment Guidelines

Many years ago here in Connecticut each of the hospitals in the state had their own set of treatment guidelines for the paramedics they sponsored. In our company some of our medics were sponsored by Hartford Hospital, others by Saint Francis Hospital.* Each hospital had a different set of guidelines, even though their medics worked […]

Passive Ventilation Study

The main question left in the wake of the study,Trial of Continuous or Interrupted Chest Compressions during CPR, that dominated the news coming out of the American Heart Association’s 2015 Scientific Sessions Conference in Orlando, Florida this past week, is “How does passive ventilation compare with positive pressure ventilation in the early stages of cardiac […]

Continuous Cardiac Compressions Come Under Scrutiny

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Several years ago studies out of Arizona and Wisconsin trumpeted continuous cardiac compressions, known as CCC or sometimes known as CCR (cardiocerebral resuscitation), as offering increased survival for out of hospital cardiac arrest. Neurologically intact survival from witnessed vfib arrests increased by 250-300%. For the first several cycles of CPR stop compressions only to shock, […]

Thoughts on Lights and Sirens: Stroke

I hardly ever go lights and sirens to the hospital. I feel so strongly about not going lights and sirens unless absolutely necessary, I wrote what became our statewide policy on lights and sirens. Although it was toned down through the various committees it went though, the gist of it remained the same. You should […]

ALS Versus BLS

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BLS outperforms ALS in terms of patient mortality outcomes. This from a study, Outcomes of Basic Versus Advanced Life Support for Out-of-Hospital Medical Emergencies, published in the October Annals of Internal Medicine authored by Prachi Sanghavi (and team) of Harvard University. The study includes cardiac arrest, trauma, stroke and MI care. The authors looked at […]

2015 AHA CPR and ECC Guidelines are Here!

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 […]


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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 […]


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I work in a high volume system.  It is not unusual to do 10 transports in a 12-hour shift.  I’m lucky if one of the calls is a good call.  By “good” I mean a call where I get to be a paramedic in a way more than routine.  Routine paramedic is asthma (duoneb), abd […]

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