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Ambulance: COVID Trends

Written by RSS Poster Medic Scribe

I have been following the COVID trend since the epidemic began.  To me, the best indicator of COVID in our area has been the hospitalizations.  Cases numbers can change based on the number of tests and who is being tested, the same with positivity percent.  Deaths, can be a good indicator, but they lag the onset of serious COVID cases by several weeks,  Hospitalizations, provided they haven’t changed the criteria for who is admitted to the hospital with COVID should be a reliable indicator of not just who is getting sick, but of the severity of the epidemic.    

Back in March and April, COVID cases at our hospital shot up precipitously as the disease burned like wildfire through our area nursing homes, reaching its zenith the last week of April, and then by the end of May fell fairly precipitously.  In those early days, nearly all the hospitalizations were people from nursing homes, elderly from assisted living, people in prisons, and group homes.  The first spike lasted until June, and then nearly disappeared entirely by the end of July.  We were...

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Ambulance: Dead

Written by RSS Poster Medic Scribe

As I approach the house with my medic pack over my shoulder and my monitor and isolation bag in my hands, two boys, maybe fifteen or sixteen, stand on the sidewalk out front of the building, and look at me expectantly.  “He’s not alive?  Is he?  Is he still alive?” the shorter one asks.

I keep walking, up the stairs and through the front door, headed for the third floor.  The fire department is there waiting for me.  They let me through.  The apartment, empty of furniture, looks under haphazard renovation.

The man who looks to be in his sixties, dressed in a blue winter jacket and a red knit hat, is on the floor.  He has rigor mortis with lividity.  With the freezing temperatures outside and no heat in the apartment it is hard to tell how long he has been dead. The boys outside apparently found him while they were doing whatever it is kids when they trespass. The building owner says the man is homeless.  He last saw him a week ago down on the corner by the ranch house restaurant. He was sick.   I don’t see any paraphernalia, but that doesn’t mean there...

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Ambulance: Drug Use for Grownups

Written by RSS Poster Medic Scribe

he lastI just finished reading Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear, an audacious and provocative book by Dr. Carl Hart, a professor of psychology and a “preeminent expert on the effects of recreational drugs on the human mind,”  in which he describes his recreational drug use, including heroin and methamphetamine.  His argument is that drugs should be regulated just like alcohol and in some states, now marijuana.  In America, he argues, we have the right to pursue life, liberty and happiness, as given us in the Declaration of Independence.  This, he says, should include the right to get responsibly high if it brings us happiness.  I am not saying “Right on!” to this argument but I’ll concede he does make some good points.  The reason people are dying of overdoses today is they are using in the shadows (driven there by law and stigma) and the drug supply in America is lethal due to poor mixing of fentanyl and the unknown additives added by dealers to fill out and or enhance their product.  Legalizing and regulating...

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Ambulance: Pandemics

Written by RSS Poster Medic Scribe

COVID is on the retreat in Connecticut and much of the nation and world.  Whether it is the effect of vaccinating those most at risk, the cumulative effective of masking and social distancing or the virus is just getting tired (hopefully not just resting before a new variant-fueled surge), cases are in rapid decline.  The COVID ACT-Now map, which in January was solid dark red, indicating uncontrolled outbreak, is now more orange than red, and I predict in a day or two Connecticut will also turn from red to yellow, indicating the level has gone from active outbreak to at risk of outbreak.  (Never mind, I just checked it again and it has officially turned orange).

Our hospital is down to less than 10 COVID patients in the hospital and I have gone two days without having to notify EMS of any COVID positives they transported.  When I work the street, I still gown up, but the patients with SATs in the 70s are nowhere to be found. 

Our Governor has announced he is loosening a number of restrictions, with more to follow.  I sure hope this is not just another...

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Ambulance: Safety in EMS

Written by RSS Poster Medic Scribe

Scene Safety BSI.  (BSI is body substance isolation). That’s what we are taught to say at the start of any practical scenario.  You don’t practice Scene Safety BSI, you fail the station.

Two interesting articles recently on Jems.com about EMS safety.

The first, Safety is Third, Not First, and We All Know It Should Be.  (The authors put safety behind 1. Getting the job done and 2. Having fun.

The second, Safety First or Safety Third: Considering Practitioner Safety in EMS, is a rebuttal.

I find the first article provocative in questioning a fundamental tenet of EMS.  It argues that EMS should be about risk assessment as opposed to absolutes.  I will let you read the articles and decipher their arguments. Some of their difference is just semantics.  They both clearly want EMS responders to be safe.  The authors of the first article think they will be safer if they are not blanketed with the Safety First Motto, which can easily loose its significance.  They prefer you think about it when it matters most.

I like the line in the first article “It...

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Ambulance: Part-time

Written by RSS Poster Medic Scribe

I admit I have been having a hard time adjusting to being a part-time field paramedic.  When I went part-time back in the spring (in order to accommodate both increased hours in my clinical coordinator job at the hospital and be around more to take my daughter to her sports events), my plan was still to work two shifts a week, which I managed to do for a while, but lately I have only been working my ten hour Friday shift.  True, it is a busy shift, in which I average 10-12 911 responses, of which I may only transport 3 or 4, but it is far less than I am used to doing in a week.  And while I miss the extra work both for the adventure and the experience, which keeps me on top of my game (or did when I was doing it), I am finding on days when I have a chance to go in and work an extra shift, I am choosing not to.  Sometimes I don’t pick up the shift because I am worried if I am held late, I will be unable to get home in time to take my daughter to her practice, other times, it will mean I will miss my scheduled swim or sometimes I admit, I just would rather...

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Ambulance: Hartford Mini-Documentary

Written by RSS Poster Medic Scribe

Great mini-documentary on opioid use and racial disparities in Hartford, Connecticut.  

Listen to Julissa’s story.  

My view’s on the opioid epidemic and people who use drugs has changed dramatically in the over twenty-five years I have been a paramedic in Hartford.  Only by listening to my patient’s stories, patient’s like Julissa did I come to understand them and to see the world through their eyes.  Harm reduction works because it accepts people for who they are and recognizes the paths they have traveled.  Harm reduction is there to help.

I agree with Julissa when she says, “We all have to learn how to love each another.  We have to learn how to wake up and be grateful each day.”

Amen.

 



Ambulance: COVID-19

Written by RSS Poster Medic Scribe

Today at our state’s EMS Advisory Board meeting (held via internet) they had a moment of silence for those in EMS who have passed recently as they do every month.  One of the deaths was an assistant fire chief and former state trooper who was one of the first responders at Sandy Hook.  He died of COVID-19 at age 50.  Other deaths included a husband and wife EMS team who both died of COVID-19 within weeks of each other.  An old partner of mine is in the hospital with COVID-19.  Another old partner of mine has been out for over a year and will likely never return to work thanks to COVID-19.

I am sure all of you who work in EMS, and even those who don’t know of similar cases.

Wear your PPE when you are on duty and wear your masks when you go out.  Get vaccinated.  We have to protect ourselves, our families, our partners, our fellow responders and the people we serve.

Stay safe.

Patrick Dragon

Don and Christine Kutz



Ambulance: Hot Zone

Written by RSS Poster Medic Scribe

The official word is things are getting better in Connecticut as far as COVID goes.  We continue to slowly decline from our December high.  The governor has lifted the sports pause so my daughter is back having full scrimmages with her regional basketball team, although her middle school has cancelled their basketball season.  My wife who works at the VA has been vaccinating older veterans at a frenetic clip, but statewide there is not enough vaccine yet to meet the demand.  I am one of the lucky 1% that has received both doses, and just 7% of our citizens have received their first dose.

I am quite glad I have been vaccinated because at least on the days I work, I have been running into many patients who either have COVID or are good candidates for COVID.  I have often thought that the people working in the ICU have it the toughest as far as witnessing the emotional toll of COVID, watching their patients slowly struggle and die or weaken severely.  In EMS, we say good bye to our patients when we leave them at the ED.  Where we have it worse in my opinion is...

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Ambulance: EMS Harm Reduction

Written by RSS Poster Medic Scribe

I am thrilled that American Medical Response-Hartford and Aetna Ambulance are partnering with the Greater Hartford Harm Reduction Coalition to deputize the city’s EMS responders into the Harm Reduction army.  Crews will provide information cards to overdose patients and their families on where they can obtain everything from rehabilitation services to naloxone and clean needles for those not ready yet for rehab.  Harm reduction, which seeks to meet people where they are at, provide honest information and keep people alive has rarely been a part of any EMS curriculum.  EMS crews will also be encouraged to report all opioid overdoses in Hartford to the state Poison control center as part of the Statewide Opioid Reporting Directive (SWORD) to provide early warning surveillance of bad batches, demographic information of which cohorts are overdosing, and develop heat maps to identify the best areas for outreach.

Gone are the days of stigmatizing users and declarations for users to just say no, to be replaced by evidence-based harm reduction truths...

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Latest Medic Scribe Stories

COVID Trends
Dead
Drug Use for Grownups
Pandemics
Safety in EMS

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