Conrad Castonguay

Conrad Castonguay died this week at 81. In 1992-93, he helped teach my paramedic class. Pharmacology was his specialty. He wasn’t a paramedic, but he knew what he was talking about and we paid him mind. He was a challenging instructor, and took his work seriously. It became an honor for paramedics to say they […]

EMS Sports Pages

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When I started in EMS, the term “EMS Sports Pages” referred to the Obituaries. It was where we turned to see how our critical patients did. Get pulses back on a cardiac arrest or bring in an unresponsive patient with multiple trauma from an MVA or a seizing patient with left sided paralysis, you checked […]

Tell Me Exactly What Happened

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I just finished reading an interesting book, Tell Me Exactly What Happened, which will be published in September by the Minnesota Historical Press. It is the second book by Caroline Burau, a former 911 call taker/dispatcher from Minnesota. It was not what I expected. When I was in EMT school, I read every book I […]

BLS Skill Creep

When an ambulance shows up at your house or an EMS scene, they ought to be able to take care of the most common complaints like pain, nausea, and difficulty breathing, to go along obviously with vfib arrest and anaphylaxis. I want the first ambulance to be able to take care of the problem, not […]

BLS Fentanyl

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A new article* published in Prehospital Emergency Care  (on-line April 8, 2016), concludes that Basic EMTs can safely give subcutaneous Fentanyl for acute pain in the prehospital setting. *Subcutaneous Fentanyl: A Novel Approach for Pain Management in a Rural and Suburban Prehospital Setting BLS EMTs in Canada received a four hour training course, and then […]

Narcan Dosing and Delivery

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The heroin epidemic continues to rage in Hartford and across our state and nation.  While nearly every other day there seems to be an article in the paper about fatal overdoses in various towns, most of the overdoses we see on the EMS streets, even the fatal ones do not make the news, though they […]

Bad Behavior

Years ago I worked for a United States Senator.  One of my early jobs for him was driving him around the state to campaign functions and speeches.  Every now and then someone would give him a hard time about all the rotten people in Washington.  He had a great answer.  He said we were a […]

The End of Pain Scales?

A bill has been introduced in Congress that will eliminate the financial penalty (in the form of reduced Medicare reimbursements) hospitals pay for failure to keep patients pain-free. Currently the amount of money Medicare pays a hospital is affected by the results of a patient satisfaction survey known as the “Hospital Consumer Survey of Healthcare Providers and […]

Amiodarone vs. Lidocaine vs. Placebo

The results are in.  In an article, Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest, published in yesterday’s New England Journal of Medicine by Peter J. Kudenchuk, M.D., Siobhan P. Brown, Ph.D, and others, the results of a major randomized double blinded study involving paramedics from ten major cities in North America (The Resuscitation Outcomes Consortium […]

Burnout (With Footnotes)

I wrote this a couple months ago when I was feeling really burned out.  The burnout passed, as I knew it would, and I am back to myself, so I can post it now. (1) I have been responding to 911 calls for twenty-six years, 21 as a full time paramedic with a busy urban commercial […]

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