NTG and The Hero Medic

My favorite stories are when medics talk about great medics from their past. The stories can be made up, exaggerated or true, but with telling they achieve the status of folklore and the medics in them are our Paul Bunyans and Davy Crockets, our Supermen and our Columbos (the great TV detective played by Peter Faulk).

I heard an awesome story that other day that I wanted to share. In this story the new medic (now a seasoned medic of many years) tells how he had a patient in severe pulmonary edema who was circling the drain in front of him. As his partner raced lights and sirens to the hospital, the medic told the partner to call for an intercept as he desperately needed help. The call went out and at the intercept point, the hero medic stepped in the back, eyed the patient, asked the new medic for the nitro, which was handed to him. The hero medic opened the nitro, pulled open the patient’s mouth and poured in what seemed like half the container. The hero medic closed the patient’s mouth, and then told the new medic. “You should be all set.” He stepped out of the ambulance (My work is done here), patted it on the side like they do in TV, and the new medic was back on his own with a patient who by the time they reached the ED was doing great, chatting comfortably with the new medic.

One of the reasons I like this story so much is that while it occurred probably a decade ago, it showed how the hero medic knew what is now and becoming increasingly so, the hallmark of CHF treatment. Not just NTG with our newest great gadget CPAP, but that high-dose nitro is what will likely save people. Rogue Medic has a nice recent post about high-dose nitro where he cites studies where patients are getting the equivalent of from 2-5 mg of Nitro IV every 5 minutes.

Nitroglycerin for Treatment of Acute, Hypertensive Heart Failure – Bolus, Drip or Both?

You can talk about the hero medic acting of protocol and being a cowboy, etc, but the story still resonates for me.

For more about EMS Folklore read Timothy R. Tangherlini’s great book Talking Trauma: Paramedics and Their Stories.

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