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Ambulance: Anti-Black Racism Class Thoughts

Written by RSS Poster Medic Scribe

I had some trepidation about taking an Anti-Black Racism course (which was offered free to employees at our hospital, and all students, faculty and staff affiliated with the University of Connecticut) but I was enthused to engage and learn so I could better understand what is going in America and how I could can better help change this country into the country that I love.  Trump had a slogan Make America Great Again, but after hearing a Bruce Springsteen sound tracked campaign ad encouraging people to vote in Pennsylvania, I reimagined that slogan into Make America Recognizable again.  This comes from the song “Streets of Philadelphia” about a person with AIDs who because of the way he is treated/shunned, loses nearly everything, and is now “bruised and battered, unrecognizable to myself.”  I have felt that America has been unrecognizable to my vision of it – a land that is a world leader and is an example for others of democracy, rule of law, truth, human rights and compassion for its less fortunate.  We...

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Ambulance: Dark Red

Written by RSS Poster Medic Scribe

I follow COVID ACTNOW daily for a look at how the epidemic is progressing or retreating.  It looks now like it is advancing so severely that they have had to add a new color/category risk level to their map.  Previously red was the worse you could do and it signaled critical – “Active or Imminent Outbreak.”  Things have gotten so bad, they have had to add dark red, signifying SEVERE outbreak.  I only pray we don’t reach the next likely level — black, meaning – DEAD, APOCALYPTIC, BEYOND HOPE, DEFEATED, WASTELAND.

God Bless America and wear your damn masks!



Ambulance: Black Friday/EMS Books

Written by RSS Poster Medic Scribe

It’s Black Friday.  When thinking of Christmas gifts, consider supporting EMS authors.

My new book, Killing Season: A Paramedic’s Dispatches from the Front Lines of the Opioid Epidemic,   is coming out on April 6, 2021, but if you order two books (or spend $50 now, you can get them for 40% off under a special promotion.  Use code HHSA when checking out at the Johns Hopkins University Press Bookstore.

My first two books, Paramedic: on the Front Lines of Medicine and Rescue 471: A Paramedics’s Stories are still available both in print and as ebooks.

 

I have two works of fiction available as ebooks.

Diamond in the Rough tells the story of a young EMT’s wayward journey through EMS. It takes place in Hartford in the similar setting to my first novel, Mortal Men: Paramedics on the Streets of Hartford.  The book has caused some controversy because the EMT narrator is a thief, who steals from his patients.  He, of course, eventually pays the price for his actions, but he does, despite his crimes, manage to find some...

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Ambulance: Thanksgiving

Written by RSS Poster Medic Scribe

I wrote this post on Thanksgiving 2005.  

***

It’s Thanksgiving morning. I awake at 5:10, shower and dress, then open up the garage door to see a couple inches of snow on the ground. It’s beautiful, but I hate winter, hate the cold weather, hate driving in snow.

When I get to the base, I can see from the tracks in the snow by the ambulance doors. The night crew is out on a call. Ten minutes later I hear them clear with a presumption. I sit in the office and drink a diet coke while I read the morning paper.

This week a thirty-year-old female cop in one of the suburban towns was murdered by her ex-boyfriend, a state cop. We had two cars on standby while they looked for the shooter. They found him a couple hours later, also dead. The paper said he parked his car at a park, and then walked over to her house so she wouldn’t see him. He lay in wait for her and when she returned from work, he ambushed her, shooting her three times, twice in the chest and once in the head. He was supposed to turn himself into court today on a police...

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Ambulance: Corona Together

Written by RSS Poster StorytellERdoc
This breath is a gift...
This moment is a gift...
This life is a gift...

As with every other person, I am struggling to comprehend the staggering effects that Covid-19 has had on our society in such a short time. Gone are the carefree smiles, the uncomplicated daily lives, and the thought that we and our families are immune to unexpected death. Instead, we are witnessing a collapse in society to the degree that most believe survival hinges on the amount of toilet paper and paper towel one has stockpiled.

Being an ER physician facing this dilemma on the front lines of a large emergency and trauma center, I am also bearing witness to the more daunting picture of this dilemma--the mental and physical effects Covid-19 is having on our patients as well as on all of us. Regardless of the severity of a patient's illness and diagnosis, time and again I am now witnessing an unsettling fear in their eyes, conveying a belief that somehow Covid-19 is playing a part in their (lack of) well-being. They are scared.

For the rest of us, any minor...

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Ambulance: Green Glasses

Written by RSS Poster Medic Scribe

This week I received in the mail, special glasses I ordered from the back of an old comic book.  They enable me to see COVID.  He is a tiny little green monster with a coat of suction cups.  He is not just one fellow, but an army of millions of little green monsters.

I sit in the ambulance and watch COVID soldiers pour of of the man’s nose, which keeps sticking out from his sagging mask.  Other hordes of green mercenaries slip out from the bottom and sides of the mask, even a few blow right through the mask.  Some of them float about in the air like spacemen in zero gravity. Many bounce off my face shield but others find purchase with their suction cups.  They stick to my gown and my hair and my pant legs which are too long for the gown that does not fit me. I try not to breathe too much as I do a 12-lead ECG, and put in an IV giving him fluid to try to rehydrate him. The green men begin to accumulate on the floor and pile up upon each other and the green man level rises like a flood, above my boots, and up my pant legs, till I was...

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Ambulance: Passengers

Written by RSS Poster Medic Scribe

Friday night in the city on a dead end street.  Light beams out of the ambulance’s open back doors.  Inside the EMT spreads a clean white sheet on the black stretcher mattress.  He hits the exhaust button on the wall, and then exits from the side doors. My masked patient steps up into the back where he lays down on the stretcher.  I stand in full PPE gear, and take in a last breath of the fresh night air and then enter the compartment.  I sit on the bench seat.  The EMT closes the door and it is just me, the patient and COVID, under the bright fluorescent lights.



Ambulance: Corona Together

Written by RSS Poster StorytellERdoc
This breath is a gift...
This moment is a gift...
This life is a gift...

As with every other person, I am struggling to comprehend the staggering effects that Covid-19 has had on our society in such a short time. Gone are the carefree smiles, the uncomplicated daily lives, and the thought that we and our families are immune to unexpected death. Instead, we are witnessing a collapse in society to the degree that most believe survival hinges on the amount of toilet paper and paper towel one has stockpiled.

Being an ER physician facing this dilemma on the front lines of a large emergency and trauma center, I am also bearing witness to the more daunting picture of this dilemma--the mental and physical effects Covid-19 is having on our patients as well as on all of us. Regardless of the severity of a patient's illness and diagnosis, time and again I am now witnessing an unsettling fear in their eyes, conveying a belief that somehow Covid-19 is playing a part in their (lack of) well-being. They are scared.

For the rest of us, any minor...

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Ambulance: ZIMHI – 5 mg Naloxone IM

Written by RSS Poster Medic Scribe

Adamis pharmaceuticals is seeking FDA approval for ZIMHI™(naloxone) Injection, a 5(FIVE) milligram IM dose of naloxone for use in suspected opioid overdose.

https://www.adamispharmaceuticals.com/zimhi-naloxone/

In EMS, we try to titrate naloxone to the smallest possible amount to reduce respiratory depression.  We have that luxury because we carry bag valve masks, which enable us to breathe for apneic or agonal patients until they are able to ventilate on their own. 

A few years ago ADAPT pharmaceuticals came out with a 4 mg intranasal product, NARCAN.  Our local fire and police departments started carrying it, and we started showing up on scene just in time for the victims to sit bolt upright and projectile vomit on us.

4 mg intranasal is roughly equivalent to 2 mg IM based on bioavailability.

The only time I have ever given 2 mg IM in one shot is when I have a patient who is not only apneic, but cyanotic and I am having difficulty finding a pulse.  Other than that, I use a lessor amount.  My preferred dose in...

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Ambulance: A Simple Dream

Written by RSS Poster Medic Scribe

Twenty-seven years ago, in a retaliatory shooting, a man in Hartford’s north end opened fire with an automatic weapon, killing his target.  He was sentenced to fifty years in prison.  He left at home a baby daughter,

***

I get called for the unconscious.  I arrive first and climb windy wooden stairs to the third floor apartment, where a terrified young woman, holding a toddler, kneels in the hallway by the open bathroom door.   “He collapsed and he won’t wake up!”.

An older man with a grey beard lays on his back, eyes rolled into his head, gurgling.  His arms are stiff.  His carotid pounds..

“What kind of medical history does he have?” I ask.

“I don’t know,” she says.  “He, he takes pills.”

“Is he diabetic?  Has he ever had a stroke?  Or seizures?”

“I don’t know!”

I have an ambu bag out and with the help of the arriving fire department we pull the man out into the middle of the living room floor, where we start breathing for him.

“Does he do drugs or drink?”

“No, no.”

“What’s your relation to...

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