When I am in the rapid response paramedic fly car, I usually always arrive on scene, before the fire department, before the police, before the ambulance. (Unless, I am requested to stage for a violent psych or an assault if the assailant is still believed to be on scene).

I carry with me my paramedic house bag, my heart monitor, oxygen tank, and PPE bag.  I try to be mindful and always get my PPE on.

The call is for unresponsive with precautions.  “With precautions” is code for patient either has COVID or screens in as a possible COVID.

I stand now outside apartment 7J.  The door is closed and I can hear no sound from within. In the pre-COVID days, I would knock, and then if it is unlocked, open the door and say “Ambulance.”  Now before knocking, I set all my gear down in the hallway.  I open my PPE bag.  I take out a yellow infection gown.  I pretie the neck loops, drape it over my head, and then twisting to the side and trying to make myself thin, I tie the waist strings (some brands have plenty of string, but these the strings...

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This is a second post looking at the January 2021 UK Government White Paper on Reforming the Mental Health Act 1983 — the first post covered proposed criteria for developments on detention in hospital, this will look at various issues to do with rights and risk.

We’re going to have to get used to spotting the difference between a “substantial likelihood” and a “substantial risk”.  My best guess is that “likelihood” would mean something approaching probable, whereas “risk” may end something closer to possible (p25).  Introduction of both terms is suggested in the paper amidst the criteria for various things – substantial likelihood for initial detention or re-detention under the Act (ie, admission) but substantial risk to authorise or review the use of Community Treatment Orders (CTOs), “a substantial risk of significant harm [without using a CTO.  It is argued, CTOs are over-used and the White Paper suggests that consideration was given to removing them from the...

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My break from blogging was deliberate decision to step back from it all but the publication of the Government’s White Paper on Reforming the Mental Health Act 1983 motivated me to think some things did need saying and summarising, for whatever that’s worth.  I was involved in this review which leads to the White Paper and I cant deny my interest in how it develops towards potential legal reform.  My first post of 2021 covered in brief some of the more-obvious police-related implications of the White Paper, written after a fairly brief read.  Having now made a more concerted effort, there are other points worth making and which are not linked (directly) to policing but are for general awareness of what may be coming.  It gives a context about the broader system in which the police will always play a limited role.

Of course, this is still just a White Paper, it changes nothing in law (yet) and the various proposals may or may not make it to the statute book.  At the first meeting of Professor Sir Simon...

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The Government has today published its White Paper on Reforming the Mental Health Act 1983 (MHA) —

This publication follows the report of Professor Sir Simon Wessely in 2018, after an independent review of the Act.  It’s 184 pages long and it covers a lot of ground, some of it surprising, some of it not.  The UK.GOV website also has a host of other formats, inc easy-read, executive summaries, Welsh language editions and so on.  This post is restricted to the police-related aspects only, for your information and consideration.  (May blog again later on the other stuff, as I’ve quite enjoyed writing this one, after many months away from it all!)

I want to highlight five main issues —

• Legislation to end all use of police cells as a Place of Safety under the MHA by 2023/24.
• Revision of s5 of the MHA, to allow for detention by healthcare staff in an Emergency Department
• Reform of s35/36 of the MHA, to allow Magistrates to remand mentally unwell defendants to hospital at first appearance
• Section 140...
  
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Connecticut is back in a severe outbreak according to COVID ACT Now.

The upgrade seems to be largely based on the daily new cases per 100K population. 

For me, I think the daily hospitalizations is a far better measure of the state of the epidemic. 

Source: University of Minnesota COVID-19 Hospitalization Tracking

The cases chart shows COVID is far worse than in the Spring, while the hospitalizations show it is not.

I know at my hospital the hospitalizations have plateaued for weeks at about 25% below their early December high and well below their high of last spring.  When I work, I don’t see the number of COVID patients as I did in the spring, although as I have mentioned before, since people don’t seem to be avoiding the hospital like they did in the Spring, the COVID cases are going to be less concentrated.

I do know that I know more people in recent weeks who have been diagnosed with COVID than I did in the spring, and I suspect this has to do with more widespread testing catching asymptomatics and those with...

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EMS continuing education has been changed forever over the course of the last year.  At UConn John Dempsey Hospital where I am the EMS coordinator, we hold EMS CMES monthly.  For years we held them in person.  Over the years we bounced around from venue to the next dealing with issues like parking (for attendees and for those on duty who needed access to their emergency vehicles when calls came in), adequate space, ability to eat and drink during the CME, noise from renovations, unpredictable computer equipment, and conflicts with other conferences, not to mention winter weather storms.  We were never able to find the right combination that met everyone’s needs.  On a good day we would get 50 people.

Then COVID came around and we were forced to go virtual using WEbex.  In no time at all, we had 100 attendees, better availability of speakers who can now teach from their works or home desks, reliable and readable PowerPoints, no parking issues, people able to attend who never could before.  For instance, every month we...

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I am writing this blog on the 7^th January and it is already an extraordinary start to the year.

January is in some ways a little bit of a blue month after the excesses of Christmas and as the days are their darkest. We have lacked excess this year and the dramatic swing in infections from COVID is sobering. I think we can all agree we are entering a very difficult few weeks now with the new strain of the disease.

This comes at the very moment vaccinations emerged and so the hope of an end has been dampened by the sense of a punishing few months ahead.

A few thoughts from me:

On New Year’s Eve I joined OSU staff on Operation Reliance and saw first-hand what I would describe as the hard grind of COVID enforcement. It is tough relentlessly dealing with people who don’t see why they need to follow the rules. I was deeply concerned by some of the parties I saw and the health risk they create, specifically to us. I am supportive of the need for government to consider public facing roles in...

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My first Pfizer shot was great.  Didn’t even feel the needle go in.  No side effects.  Shoveled my driveway the next day with no fatigue.  Yesterday at 10:30 A.M., I had my second shot.  Went to bed at 9:30 P.M. feeling fine.  Woke up at 11:00 P.M. feverish, chills, body aches, joint aches, bone aches, muscle aches.  I couldn’t lay on my left arm were I got the shot it hurt so much.  My wife kicked my lightly and I thought she’d broken my leg it hurt so bad.  Woke up on the hour, trying to lay as still as I could.  Fever this AM of 102.1.  Heart rate of 104 (I live at 60).  Now I have a headache that’s getting worse.  Good to know I have a functioning immune system.

The Common Side-Effects Of The Pfizer Vaccine