Archive for October2017

Hope

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The call is for an overdose in the stairwell of the apartment building. Fire has arrived just before us – they have propped the front door open. I enter with my house bag over my shoulder and carrying the cardiac monitor in my right hand. There is no one in the dim lobby to direct […]

Controversies and Carfentanil

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Great article in the November 2017 edition of the  American Journal of Emergency Medicine about the  controversies surrounding the dangers of carfentanil, fentanyl and other fentanyl analogues.  The physician authors, John B. Cole and Lewis S. Nelson, take the Drug Enforcement Agency (DEA) and the media to task for sensationalizing the dangers to responders of these synthetic opioids. […]

Endocarditis

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The patient is “a skin popper.”  She injects heroin into her skin rather than snorting it or injecting it directly into her veins.  Her arms are covered with sores in various stages of ulceration from old scars to open weeping sores.  example of skin popper The ambulance crew is there not for an overdose, but for […]

Non-Opioid Pain Management

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The state of Massachusetts just passed an emergency protocol change requiring all paramedic ambulances to carry non opioid pain management alternatives, including Ibuprofen PO, Acetaminophen PO and Ketorolac IV or IM.  Acetaminophen IV is optional.  The changes are to take place January 1, 2018. Massachusetts Pain Management Protocol Emergency Non-Opioid Pain Treatment Options Update Here […]