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Faces of Life and Death

Earlier this week I did a cardiac arrest at a nursing home. I arrived to find an elderly patient apniec and pulseless. The patient was quite large and had a lifeless face with a small amount of facial hair that made it difficult to ascertain gender. The nursing home staff had last seen her (she […]

Minimally Interrupted CPR

There is another new study out (published in the March 12 Journal of the American Medical Association that may change the way we do CPR, continuing the emphasis on “Minimally Interrupted CPR.” Minimally Interrupted Cardiac Resuscitation for Out-of-Hospital Cardiac Arrest Here the jist of the protocol: This novel approach, aimed at maximizing cerebral perfusion, involves: […]

Zen Masters and Gizmos

I’ve been precepting a new part-time intermediate. He needs 15 IV starts in the field. He may have five or so. (We only work together once a week.) He doesn’t quite have the hang of it yet. I tell him not to worry about missing because when you miss you learn what not to do […]

Epistaxis-Syncope, SYNCOPE-HYPOTENSION-epistaxis

The call is for a nosebleed. Person unconscious in a car. We get updated that the patient is now conscious, but still some bleeding from the nose. The first responder tells us the man has had a nose bleed all day and finally called a neighbor to drive him to the hospital. On the way, […]

A Choice

A couple years ago I decided I wanted to become a triathlete. Call it a middle aged crisis, but I started training regularly and last year completed six triathlons. These triathlons were not the same distance as the famous Ironman triathlons, which include a 2.4-mile swim, a 112-mile bike and a full 26.2-mile marathon at […]

Hands-Only CPR

The AHA has issued a new Hands-Only (Compression Only) CPR advisory. The advisory applies to bystanders, not professional rescuers. When you see an adult suddenly collapse, use Hands-Only CPR: that’s CPR without mouth-to-mouth breaths. And it can help save lives. Hands-Only CPR is CPR without mouth-to-mouth breaths. It is recommended for use by bystanders who […]

Driver's Seat

We’re called for an unresponsive at the movie theatre, but are soon updated that the patient is conscious and breathing. As we pull into the parking lot, we see a police car next to a green Oldsmobile, and the officer looking in the passenger door. The officer comes over and talks to me as I […]

Story of the Shift

I rise early in the morning. I shower and shave. I put on my working clothes and lace up my black boots. It is dark outside. I drive through deserted streets to the ambulance base, where I punch in — always fifteen minutes early (even though I don’t get paid until the top of the […]


We get called for a medic alarm. “Eighty-year-old man having a problem with his aneurysm.” Odd. Just before we get there we hear the first responder call for backup saying “There is a lot of blood here.” I make certain to grab a pair of gloves before I enter the house. The door is ajar. […]


The hospitals have been really overcrowded lately. I had two calls the other day that are becoming increasingly common.* The first was for a woman with a low oxygen saturation called in by the visiting nurse who was concerned the 90-year-old woman’s oxygen saturation was at 90, her heart rate 100, and her BP 180/90. […]

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