Continuous Cardiac Compressions Come Under Scrutiny

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Several years ago studies out of Arizona and Wisconsin trumpeted continuous cardiac compressions, known as CCC or sometimes known as CCR (cardiocerebral resuscitation), as offering increased survival for out of hospital cardiac arrest. Neurologically intact survival from witnessed vfib arrests increased by 250-300%. For the first several cycles of CPR stop compressions only to shock, […]

Thoughts on Lights and Sirens: Stroke

I hardly ever go lights and sirens to the hospital. I feel so strongly about not going lights and sirens unless absolutely necessary, I wrote what became our statewide policy on lights and sirens. Although it was toned down through the various committees it went though, the gist of it remained the same. You should […]

ALS Versus BLS

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BLS outperforms ALS in terms of patient mortality outcomes. This from a study, Outcomes of Basic Versus Advanced Life Support for Out-of-Hospital Medical Emergencies, published in the October Annals of Internal Medicine authored by Prachi Sanghavi (and team) of Harvard University. The study includes cardiac arrest, trauma, stroke and MI care. The authors looked at […]

2015 AHA CPR and ECC Guidelines are Here!

The long wait is over. The AHA 2015 CPR and ECC guidelines are finally here. For the first time in many cycles, there are few changes. No, you will not have to relearn CPR, and your drug kits will not see an overhaul. The guidelines finally offer a lukewarm acceptance (“it may be reasonable”) to […]


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People are always asking me what changes I have seen over the years.  Here are four changes I have been thinking about lately. More paramedics.  When I started we had anywhere from two to six paramedics on to cover the entire city of Hartford and backup the other three large towns we covered.  On many […]


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I work in a high volume system.  It is not unusual to do 10 transports in a 12-hour shift.  I’m lucky if one of the calls is a good call.  By “good” I mean a call where I get to be a paramedic in a way more than routine.  Routine paramedic is asthma (duoneb), abd […]

The Finger

I have been injured seriously enough to miss work twice in the last two decades.  Neither time was I injured on the job.  The first injury was playing softball on our ambulance team (back when we had one). I went from first to third on a single, and as the third base coach signaled me to […]

Assembly Line

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Many years ago, I worked on assembly lines in factories.  I put together and or packaged everything from Christmas Tree stands and door knobs to fast food store deli sandwiches and grocery store beef ribs. The key to the assembly line was to go a little bit faster than you were comfortable going.  You had […]

Patient Follow-up

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One of the greatest shames in EMS is that we so often never find out what the real deal was with our patients. 17 year old boy whose parents swear he never does drugs (but did go to a concert last night) is found in his room the next day talking gibberish, reaching for objects […]

Paramedic Students

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I remember when I was an EMT student doing my hospital observation time and watching the paramedics come into the hospital with their patients.  How confident they seemed.  I marveled at the ease with which they moved through this strange new world.  I held them in awe as I did the paramedics I later rode […]

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