When intubating preattach the ETCO2 to the tube.  If you have a narrow stylet, this is possible.  Attach the ETCO2 to the monitor.  If I have trouble seeing the chords, I hand the tube to my assistant, then using my right hand apply crick pressure until I can see the chords, then I have my […]

Make certain the CPR and airway management are being done properly. When I started our protocol said to intubate immediately.  On arrival, I would turn my back on the code and take the two minutes it takes to get my intubation roll out, unzip everything, take everything out, open the packages, assemble everything and then […]

You can’t work an arrest if you don’t have space to do effective CPR. I often come into a bedroom where responders are trying to work a code, and I will flips beds up on their sides, clear out couches, or if the patient is wedged in the bathroom, haul them out into the hallway, […]

Charge your defibrillator before looking at the rhythm. Whether you and your partner are the first person at the patient’s side or first responders or laypeople are already doing CPR on your arrival, initiate and/or keep CPR going while you apply your pads.  Then with CPR still continuing, charge the defibrillator.  Only then stop CPR […]

  Cardiac Arrest.  Pearl #1  Recognize cardiac arrest. This sounds obvious, but it is not always so.  Early cardiac arrest can present like a seizure or syncope.  The patient’s eyes may be open and they may have agonal breathing.  Get the pads on!  Too many times I have shown up on scene to see first […]

Paramedics all take ACLS every two years, and we all have roughly similar protocols. We all know that the key to resuscitation is high quality CPR and early defibrillation. I love this graph I found on Rogue Medic‘s blog a number of years ago. This graph is the answer to the test. We read about the […]

This was sent to me by an old medic.  This is how stretchers were when I started in 1989.  In the days of the dead lift, careers in EMS were much shorter than they are now.  I remember each new stretcher innovation as they arrived, and fought against them all, but within days was sold […]

Mark Jenkins of the Greater Hartford Harm Reduction Coalition passes out fentanyl test strips as part of his mobile needle exchange. He has set up on a Sunday in the parking lot of 1200 Park, a shopping plaza/strip mall across from Pope Park where users often congregate. Once the users see him out there, word […]

A federal judge ruled yesterday that a nonprofit group in Philadelphia’s effort to open a safe injection site where people can use drugs under medical supervision does not violate the federal crackhouse statutes prohibiting the operation of a space “for the purpose of manufacturing, distributing or using controlled substances.”  U.S. District Judge Gerald McHugh wrote: “The ultimate […]