Sometimes I wonder what he was like years ago before pain and need and abuse came to call.

A cigarette often works better than brute force, better than pepper spray, handcuffs, Haldol and Ativan. It’s a simple acknowledgement that a person is having a difficult day and needs a break, a chance to have a smoke and collect yourself before heading on into another tough day.

The good (get an airway that works quick and avoid any CPR interruptions) medic hasn’t completely defeated the bad (I gotta get my tube) medic but there is hope for me.

The take home message for me is when used to treat prehospital pain morphine and fentanyl are safe. Do not be afraid to treat your patients out of fear of causing adverse effects.

Sunday was Father’s Day. It was busy at work. I had promised myself I’d write a blog post, but I got side-tracked when I got home.

The bottom line is this physician has come up with an interesting and bias-free pain management protocol. You apply the same protocol to anyone in acute pain. Young, old, black, white, male, female, rich, poor.

29 diagnoses including dementia, labored breathing, gurgley rhonchi throughout, Diaphoretic, temp of 104.1, Doesn’t fit on stretcher, keeps falling to the side, Yankeur suctioning thick brown sputum.

Other morning I come in, move the gear, check the ambulance. All seems well.

The only difference between now and my younger years is it is easier now to pick myself up when I fall. If I miss an IV or am off base in my assessment, it doesn’t crush me like it used to. Learn and move on. And when I do a really good job, well, I’ve been humbled too much to stick my chest out too far.

These are not the only two times epi 1:1000 has been given IV. It is, in fact, a not uncommon error. Whether the medic is a fool or an excellent medic badly screwing up, the fact is the drug is right there in the kit waiting not just to save a life, but to take one.