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Pain Manifesto

I give a lot of pain medicine to my patients, but from everything I am reading I am not giving enough. In the last week I gave pain medicine to the following: 1. An 80 year old man with a compression fracture of the lower back. He slept all the way to the hospital. 2. […]


We are sent for a man with lung cancer difficulty breathing. Visiting nurse on scene. We’ve been going to this house a lot recently. Small one story house in a lower middle class neighborhood. The grass in the yard is mostly dead, the driveway cracked. The house needs painting. The stink hits you from the […]

Ambulance Driver

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With apologies to Steve Berry’s “I am Not an Ambulance Driver,” here’s a story from Las Vegas. It’s Friday, my friend and I go down to the pool to have a few beers and take in some sun before going out to the Jeff Beck concert, and then heading home the next day. I bring […]

Go Ahead

Morphine for undifferentiated abdominal pain. I’ve written about it. I’ve advocated for it. But until yesterday, I hadn’t ever given it. At our last regional council meeting we approved the use of .05 mg/kg for undifferentiated abdominal pain on standing orders. .05 mg/kg is half the regular morphine for pain dose. It is a “judicious […]

Too Busy

Writing about the daily life of EMS always creates a tension for me. On one hand I want to write about the nobler aspects of the job, on the other, much of the job is so frustrating you just want to scream. I try to avoid whining so most of the time I ignore it. […]


I returned last night from the EMS EXPO in Las Vegas. I love going to these EMS conventions. The classes are great. You meet new friends and get reacquainted with old ones. You get to hear the best speakers and get updated on all the latest research and ideas, and you can wander the convention […]

Las Vegas

Just a brief post. (Internet access is $7.50 for 15 minutes.) Interesting conference. I just got out of the Capnography class and it was great. I made some notes and will be posting when I return. I was on the EXPO floor yesterday and it was mind-numbing. EMS is such a huge business. So many […]

I’m headed out to Las Vegas for the 2006 EMS EXPO. I’m planning on attending two of the three conference days, and then spending the third day playing poker and attending the Jeff Beck concert at the House of Blues that night. I also want to get in some baking in the desert sun pool […]

A Life

I recently did a presumption. A sixty-eight year old man found cold and stiff in bed in his one bedroom apartment in an elderly housing complex in town. He died sometime during the night, curled on his side, his head pressed against the pillow, a quilt pulled up to his neck. I couldn’t imagine a […]


We spent the first three hours of the shift covering a suburban town while their ambulance was on a call. There were reports of gunshots in the city, but when the ambulance got there the supposed victim had fled. Nothing else was going on anywhere, so it wasn’t like we missed a lot. My preceptee […]

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