Category Archives:

Fentanyl: The Real Deal

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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 […]

Safe Injection Sites

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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 […]

Epinephrine in Cardiac Arrest

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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 […]

Veins

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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 […]

Pulmonary Edema in Opioid Overdose

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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 […]

Slipping Out

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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 late fifties, a portly man with white […]

Rescue Breaths or Compressions in Overdose?

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  Should unresponsive overdose victims receive rescue breaths or chest compressions from lay bystanders? If a person is apneic but not in cardiac arrest, failing to give rescue breaths may lead this person to fall into cardiac arrest. But, if the person is apneic and in cardiac arrest, failure to do quality chest compressions, will […]

Follow Up

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Overdose on Babcock Street. In an alley behind a building. Fire is there before us. A familiar scene. As I approach I can see them hunched over the patient, the bag valve mask out. They have already given her four of narcan. I stand over them looking at the patient. I can’t see her face […]

Undetermined

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Opioid deaths are generally classified as accidental overdoses. In 2017 Massachusetts began reporting opioid deaths as “All Intents” where they previously reported them as “Unintentional/Undetermined.” They point out that adding suicide deaths only marginally adds to the count. By their statistics only 2 percent of the total opioid deaths were confirmed as suicides. Massachusetts Opioid […]

INSIDE LOOK AT LIFE AS AN EMT

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I recently participated in a project to describe the daily routine of an EMT to help people considering a career in EMS.  The final product was published this week on the website below. INSIDE LOOK AT LIFE AS AN EMT Here is an excerpt: 5:30 AM: I punch in and checkout my equipment, my house bag […]

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