Devil Around
Police in Holyoke, Massachusetts are warning about a new heroin mixture that may not respond to naloxone, It allegedly produces violent reactions in its victims. The mixture contains the synthetic cannaboid MDMB-4en-PINACA . Holyoke police warn about new drug mixed into heroin that causes ‘violent’ behavior, may not respond to Narcan “ The article is […]
A Ravine in Winter
There is a picture in the Hartford Courant of Mark Jenkins talking with police officers looking as forlorn as I have ever seen him. They stand next to yellow tape sectioning off an area of woods just off Park Terrace where down a small ravine a man has been found dead. The paper describes the crime […]
25 Years
I hit my twenty-fifth anniversary at work last month. Twenty-five years full time as a paramedic. I am sixty-one years old now and feeling the wear and tear, particularly in these last two years. I don’t sleep well at night. My hearing is shot. I need a stronger prescription for my reading glasses (which I […]
Missing
She frequented a neighborhood park near the hospital. I’d see her times smoking a cigarette while she sat on the playground swings. Many nights, she slept on cardboard by the fence, sometimes she tied a tarp from the fence down to the grass to provide shelter on rainy nights. She was tall and gawky with […]
Pearl #9 Don’t Be Prisoner to the Clock
Don’t be held prisoner to the clock. Stay and work the patient as long as believe you have a shot. There is nothing magic about twenty minutes. I have on several occisions shortly after the 20-minute limit was talked about, gone into another room or out to the ambulance to call medical control for permission […]
Pearl #8 Anticipate LOSC
Anticipate LOSC (Loss of Spontaneous Circulation). Once you have pulses back with ROSC (Return of Spontaneous circulation) anticipate you will lose them and have your plan in place. Premix your epi or norepi-drip and have it ready to go. Don’t start moving the patient immediately after getting ROSC. I usually wait 5 minutes to get […]
Pearl #7 Use ETCO2 to Predict Arrest Cause
If two identical twins are standing next to each other at a family reunion, and one chokes on a sandwich leading to cardiac arrest, and the second suffers a simultaneous VF arrest, and two medics arrive exactly 5 minutes later, and both patients are intubated at the same time, will their ETC02 numbers be the […]
Pearl # 6 Use ETCO2 to ensure CPR Quality
ETCO2 measures cardiac output. The better the CPR, the higher the cardiac output. The higher the cardiac output, the higher the ETCO2. While the American Heart Association recommends you switch compressors every two minutes during a cardiac arrest to prevent compressor fatigue. A fatigued compressor can’t maintain consistent CPR. The compressor tires, the cardiac output […]
Peter Canning
Naloxone in Cardiac Arrest
Hi Monica- I am sorry for the tragic loss of your son. I can't imagine the grief you must feel. The AHA now says first responders can give naloxone if they are uncertain a patient is in true cardiac arrest, where a paramedic would have a heart monitor that would enable them to view the…
2020-03-25 11:27:12
Naloxone in Cardiac Arrest
My 19 year old healthy son collapsed due to cardiac arrest. First responders ( my daughter called 911 and stared CPR) gave my son Narcan first ( 2 doses) and then started an airway and the epi. My son was pronounced dead less than an hour later. My daughter told the paramedics that my son…
2020-03-25 05:43:41
Corona Cough
I have chronic bronchitis. We all feel this way. I playfully accuse my children of carrying coronavirus at a mere clearing of the throat or the slightest sniggle. Sadly, we are more at risk. I won't scold you for waiting for the crowds to die down for your own safety. They are afraid, but they…
2020-03-24 06:57:38
96
I work as a medic in San Francisco, and there has definitely been a huge decrease in the amount of people visible. It makes total sense that when you shut down the gyms, people are going to choose to go for a run or a walk. It also makes sense that they’ll pick a scenic…
2020-03-19 18:38:49
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