Blogs from Police &   
 other Emergency Service Workers
Blogs
Shop
Rankings
Contact
       
Police
Fire
Ambulance
Military


Ambulance: Common Cardiac Arrest Mistakes: Naloxone

Written by RSS Poster Medic Scribe

This is the third in a series of posts on common drug mistakes some EMS responders make during cardiac arrests.

You find the fifty year old man supine on the floor with the fire department doing CPR. Their AED announces, “No shock advised. Continue CPR.”

You set your monitor by the man’s head and connect the fire department’s pads to your monitor, while your paramedic student quickly places an IO in the man’s tibia. As you approach the two minute mark, you charge the monitor, and then order stop CPR. The patient is in asystole. “Continue CPR,” you say, as you harmlessly dump the charge by hitting the joule button.

Just then the man’s wife announces, “Oh, my God! He was using heroin.” She holds the empty bags she has just found in the trash can. “He used to use. He’s been clean for five years.”

What drug do you give?

***

Epinephrine.

According to the 2010 AHA Guidelines

There is no data to support the use of specific antidotes in the setting of cardiac arrest due to opioid...

This ambulance blog continues, Read More...



Ambulance: Common Cardiac Arrest Mistakes: Sodium Bicarbonate

Written by RSS Poster Medic Scribe

This is the second of three posts about common cardiac arrest drug mistakes some EMS personnel make on a routine basis.

You have been working a cardiac arrest for a 54-year-old male with no prior medical history who collapsed after grabbing his chest.  You shocked him twice for fine vfib, but now he is in a PEA. It’s been 20 minutes since you started ALS interventions and another medic suggests you try sodium bicarb.  What do you do?

Remember it 2019, not 1979, 1989, 1999 or 2009.

Unless the patient has preexisting metabolic acidosis, hyperkalemia, or tricyclic antidepressenat overdose, (which this patient clearly does not) sodium bicarb is not recommended by the AHA.  In 2010 sodium bicarb was made a Level 3 Recommendation.  Level 3 means it is not helpful and may be harmful. In 2015 that recommendation was reviewed and maintained.

While you should always follow your protocols and your local medical direction, in Connecticut, sodium bicarb in cardiac arrest is reserved for “suspected...

This ambulance blog continues, Read More...



Ambulance: Cardiac Arrest Mistakes: Amiodarone

Written by RSS Poster Medic Scribe

You and another medic are on the scene of a cardiac arrest. You find the patient in ventricular fibrillation and immediately defibrillate him into a narrow complex rhythm. You have pulses back and while you take a blood pressure – 130/84, the other medic inserts an IV. The other medic then says to you, “Pass me the amiodarone.”

What do you do?

A. Pass it to him.
B. Say, “No.”
C. Say “Why?”

You go with C. The other medic says, “To give to the patient (Dummy!). He was in v-fib.”

You say, “No, it’s not indicated.”

Who’s right? You or the other medic.

It is amazing how many medics have different views on this question, and some of this depends on when they were trained and how well they have kept up on changing guidelines. It also depends on their local medical control and the protocols they operate under.

Here in Connecticut our state protocols for cardiac arrest call for amiodarone or lidocaine for patients “unresponsive to CPR, defibrillation, and vasopressor therapy.” There is no...

This ambulance blog continues, Read More...



Ambulance: It's Not About The Pus

Written by RSS Poster StorytellERdoc
To Dr. Sandra Lee. Heartfelt thanks for humanizing medicine and for inspiring along the way...

Several years ago, my daughter Emma introduced me to some videos on YouTube of a dermatologist from California who posted her sometimes shocking but always intriguing encounters with patients who suffered from a variety of dermatologic issues. Of all of these videos, it seemed like the ones which made Emma happiest to watch were the videos in which this doctor's treatment resulted in gallons of pus draining from some part of the patient's body.

Well, okay--Emma liked pus and blackheads. Well, pus and blackheads and massive lipomas (fat-based tumors). Well, pus and blackheads and massive lipomas and big hairy moles. Well...

You get the picture.

With some great finesse and skill, and with a good mix of humor and learning, Dr. Sandra Lee, better known as Dr. Pimple Popper, was able to help many embarrassed patients survive their dermatologic issues, all the while captivating my daughter's interest. "Eewww, gross," Emma said. "Let's...

This ambulance blog continues, Read More...


Police: THE SUN SETS ON LAY MAGISTRATES

Written by RSS Poster The Justice of the Peace
The government departments which have the greatest influence over the manner of the work that Justices of the Peace undertake are, surprise surprise, the Home Office and the Ministry of Justice. In May 2006 a previous Home Secretary John Reid admitted that when he was the incumbent the department was "not fit for purpose".  His honesty then has been borne out many times since.  The current prime minister oversaw so many failings when she was Reid`s successor it should have been a red light to her colleagues when she was placed in Downing Street purely as the least objectionable of a rum lot. But the lemmings in the Tory Party allowed themselves to be led towards the inevitable cliff where her and their incompetence are likely to bring at the best,  years of political and economic problems and street violence and a Marxist government at worst. 

Faced with the problem of the Isis teenager from East London telling the media she has no regrets over her actions and expecting public sympathy the current Home...

This police blog continues, Read More...


Fire: Don't let your Valentine's Day go up in smoke

Written by RSS Poster Merseyside Fire & Rescue Service - Latest News
Don't let your Valentine's Day go up in smoke


Police: A 10 Point Plan for Policing

Written by RSS Poster policecommander

I’m sitting on a train bound for Cardiff where, later today, I will have the privilege of spending a bit of time in the company officers and staff from South Wales Police. I’ll be talking to them about the day I fell seriously ill and the reasons why I think it happened. I’ll be telling them about the long, long road to recovery.

I love policing with all my heart and soul – I always have and I always will. It’s a heck of a job though – placing the kinds of demands on people (body, mind and soul) that most of the rest of us would struggle to imagine, much less endure. Police officers go where most wouldn’t and they do what most couldn’t. I love them for it.

But as I look round me in policing at the moment, I see more good people operating under substantially more strain than at any previous point in my lifetime. Crime is rising – certainly crime of the most serious kinds. Levels of recorded knife crime are now the highest they have been since the end of World War II. Demand is rising too, not least as a...

This police blog continues, Read More...



Ambulance: 4, 3, 2, 1 And 90.

Written by RSS Poster StorytellERdoc
Everyone you meet is fighting a battle you know nothing about. 
Be kind.
Always.

One of the largest problems in our ER, it seems, is that there is a subset of patients who visit us on a routine basis. Commonly known as "the regulars," these familiar faces are sprinkled throughout our day between all our other patient visits. Whether it be for chronic pain, for chronic illness, for companionship, simply to have a place to hang out for a few hours, or to get some food, we are often inundated with these patients at the most inopportune times. Three trauma patients, four chest pain patients, two stroke patients, seven respiratory distress patients, three lacerations, two compound fractures, and five sick kids--and arriving between all of this organized commotion of providing good care are Johnny, Sally, and Herb, with a combined total of over two hundred visits between them.

It is a real problem in our ER. It is a real problem nationwide.

Of course, the most compassionate thing to do would be to sit down and spend some time with...

This ambulance blog continues, Read More...


Police: DECRIMINALISE DRUG USE

Written by RSS Poster The Justice of the Peace
I have long been in favour of the decriminalisation of drugs which are currently prohibited; heroin, cocaine and marijuana and the derivatives manufactured to get round current regulations which are sometimes more lethal than the originals on which they are based.  In the case of marijuana many jurisdictions have already legalised the drug in particular form.  The swinging sixties so called was an era of "weed" or "joint" or "squiff" the active ingredient of which is  tetrahydrocannabinol. However, already more than 70 different cannabinoids have been identified so far. These compounds have a chemical structure that is much related to THC, but their biological effects are quite different.  The current popular derivative among users is commonly called "skunk" which is a vastly different product and has more serious side effects than its ancestor of half a century ago.  Users of this and other prohibited substances have no knowledge of what they are taking and almost every day news media contain tragic stories of the...

This police blog continues, Read More...


Ambulance: Service Dogs for First Responders

Written by RSS Poster Medic Scribe

A fellow paramedic here in Hartford, Greg Shovak runs a great educational program called EMS and PTSD – Learning from Combat Veterans to Understand PTSD.  I attended one of his sessions a few years ago and thought it was excellent.  I learned a lot of PTSD, and also had my first introduction to service dogs.

Here is his organization’s facebook page, which has lots of great information:

EMS and PTSD

Service dogs are not just for combat veterans, but also for first responders.  Several of the medics I work with (including Greg) have them and they often bring them to CMEs.  Their dogs are awesome and that means something coming from me (see my dog history below).  I can see how the dogs bring them great comfort.

Greg has been a true leader in helping those in EMS recognize and seek help for their PTSD.

Here are a couple articles he recently wrote on PTSD, including one that mentions his own service dogs.

https://www.emstoday.com/emerging-voices-content/2018/12/makingstrides.html


This ambulance blog continues, Read More...




Blog List

Crime and Justice - UK Crime News (5431)
Surrey Constabulary Blog (4582)
Tony McNally (2896)
Rogue Gunner (1466)
Fire Brigades Union (1264)
The Justice of the Peace (1206)
Hampshire & Isle of Wight Air Ambulance (806)
News (752)
UK Forces Afghanistan (750)
Tyne and Wear Fire and Rescue (657)
Shijuro is not georgedixon's Blog (562)
200 Weeks (561)
RetiredAndAngry (559)
Crime and Justice – UK Crime News (533)
Merseyside Fire & Rescue Service - Latest News (491)
A Just Future: Fair for All (401)
Allcoppedout's Blog (394)
The Magistrates' Blog (388)
The Official British Army Blog (367)
POLICE INSPECTOR BLOG (366)
Leominster Fire Station (323)
Daly History Blog (311)
Mental Health Cop (296)
Norfolk Fire Service (280)
MentalHealthCop (262)
Hogdayafternoon (257)
Crime & Justice - UK Crime News (248)
InsomniacMedic (219)
The Thinking Policeman: A Police Officer's Blog (208)
ActionFraud's blog (196)
Trying My Patients (193)
Trauma Queen (178)
MinimumCover - The Police Officer Blog (170)
Crimestoppers (169)
Shropshire Fire and Rescue Service - News (162)
Street Watch: Notes of a Paramedic (158)
Old Plod (158)
LONDON FIRE JOURNAL (154)
Tales from the Metropolis (139)
Dave B (138)
Garth Marenghi (128)
Shijuro (nearer Go-juro though...) is not georgedixon's Blog (123)
The Thin Blue Line (118)
PC Bloggs - a Twenty-first Century Police Officer (116)
Constable Chaos - UK Police Blog (116)
PlumisAutomist (114)
PC Richard Stanley (113)
World Weary Detective (109)
Kids Firefighter Blog (103)
inspguilfoyle (101)
Medic Scribe (97)
Medic Scribe » Medic Scribe (96)
Xf (92)
Shijuro (nearer Go-juro though...) is not georgedixon's relatively honest Blog (91)
Rafairman's Blog (86)
policecommander (78)
Out of battle (77)
CC Dave Thompson (74)
Minimedic's Blog (71)
windsorfirestation.co.uk (66)
(66)
James Patrick (63)
Justice and Chaos (63)
Noddy (61)
A Life In The Day Of A Basics Doc (57)
A Special Blog (57)
StorytellERdoc (54)
Highlands & Islands Fire & Rescue News (53)
Response Plod (52)
Brian Kellett (dot) Net (49)
Hampshire Fire & Rescue News (49)
Chiefs Blog (48)
The Blue Light Run (46)
Medic ScribeMedic Scribe (46)
Leominster Fire Station (Stn 52) (45)
The Police Debating Directive (41)
Matt Delito (40)
DCC Dave Thompson (40)
ListMessenger News and Updates (40)
Alerter - the firefighters blog (39)
McNoddy (38)
Spamford Police (37)
Newsletter RSS Feed (36)
InspJulietBravo (34)
Joe90 (31)
Area Trace No Search (27)
Catemoore's Blog (27)
Policeconomics (27)
Brutal Police Blog (26)
Jerome Mowat (26)
The Sleeping Policeman: A Former Police Officer's Blog (26)
Bystander (26)
TopOfTheCops.com (25)
Disgruntled (25)
Old Plod of Plympton (25)
Anonymous (25)
Mack (24)
thestation-sergeants-blog (22)
BrianKellett.net (22)
PC Bobby McPeel (20)
Emergency Egg (19)
WHICHENDBITES (18)
Shropshire Fire and Rescue Service (18)
Political Police (17)
ambcontrol999 (17)
Essex Police (16)
MinimumCover (16)
manyvoices Blog (16)
Policing in Dudley (14)
Hampshire and Isle of Wight Air Ambulance (14)
South Coventry Police News & A Bit More (12)
Anti Winsor Network (12)
response sarge (12)
SConTutor's Blog (12)
(12)
CopShopUK Blog (12)
Purpleplus (11)
Performance and Strategy (11)
Minimedic's Musings (11)
Regie (11)
Constable Chaos – UK Police Blog (11)
Dysfunctionalcop's Blog (10)
A Copper's Special Blog (10)
Superintendent Mark Payne (10)
Shijuro (nearer Go-juro though...)is not georgedixon's Blog (10)
The Peel Blog (10)
Shijuro (nearer Go-juro though…) is not georgedixon's relatively honest Blog (10)
NursaMedic (10)
Random Cop (8)
Met Training Officer (8)
Not the Daily Mail (8)
The Adventures of Policeboy (7)
Random Acts Of Reality (6)
(6)
ListMessenger.net (6)
Jasper The Dummy (5)
Insp Winter (5)
Emergency Shorts (5)
Spanish Country Homes (5)
横浜の風俗アルバイトは初心者でも安定した収入が期待できます (4)
Panda Talk (3)
policeaircrew (3)
(3)
RoryGeo on Crime and Justice (1)
Emergency Services Show (1)

About

Emergency Shorts:
Blogs and short stories from those who look after everybody else. Police, Ambulance, Paramedics, Fire Fighters and Military Soldiers, they work tirelessly to help and protect us.

If you're an emergency service worker, start posting your stories and thoughts- don't worry you can post under a pseudonym if you like.

If you want your blog to be included on Emergency Shorts and we'll add it to the list.