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Ambulance: Lights and Sirens

Written by RSS Poster Medic ScribeMedic Scribe

New Picture (24)

 

Kevin Grange’s new memoir is now out.

Lights and Sirens is an authentic, compelling narrative of Grange’s journey through UCLA paramedic school and field internship on Los Angeles’s dangerous streets as he trains to save the lives of victims of heart attack, stroke and trauma. Grange is an excellent writer who does a great service to his new profession in conveying not just the accurate details and heart-pounding excitement of the job, but also revealing the essential compassion of the truest caregivers. Lights and Sirens is a book to be appreciated by both the general public and the fire and emergency medical services community.

Here is a link to Grange’s web site.

Lights and Sirens

Lights and Sirens can also be ordered from Amazon at this link:

Amazon

I’ll have more to comment about the book later this week, but for now, check out this video.

https://www.youtube.com/watch?v=DtusYhWjk2U

 



Ambulance: Mirrors

Written by RSS Poster Medic ScribeMedic Scribe

In the late 1970s and 1980s, the G——Motor Lodge out on the Turnpike was the place to take your girl for a swinging good time.  Mirrored ceilings and heart shaped Love-Tubs.    The brochure featured a hairy-chested mustachioed man in a velvet bathroom holding a bottle of champagne in one hand and a filled glass of the same in the other.  Need I say more.

Whenever I returned to Connecticut with a new friend from a different part of the country, my New England tour for her included three stops — Fenway Park to see the Red Sox,  Cape Cod to see the Atlantic Ocean and the G–  to see the Love Tub and mirrored ceilings.  All three were big hits.

Times change, years pass, we grow old, and so did the G—.  It’s still open, and while it looks the same form the outside, the clientele has changed.  It is a welfare hotel now.  We get called there periodically for several day old dead bodies, drunks, psychs, and assaults.  The last time I went there was for a lift assist.  A man of my age who life has treated much worse than it has me.  He was...

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Ambulance: Intranasal Narcan for All

Written by RSS Poster Medic ScribeMedic Scribe

I was on Park Street last week headed in to El Mercado to get some pernil(roast pork), yucca and tostones for lunch when a gentleman came up to me and showed me his overdose kit.  He said he’d gotten it at the local needle exchange program.  He said he had already used it once when one of his buddies ODed and it worked great (though his friend was initially a little pissed at him, but later came to understand when the friend smacked him and said, “But you weren’t breathing, bro!”.  The kit contained two 2 mg prefilled Narcan syringes and one atomizer.

photo (28)

photo (27)

 

My EMT partner Jerry just stood there shaking his head.  He didn’t understand how some dude on Park Street could give Narcan to his overdosed buddy, but as an EMT Jerry couldn’t give it.  In Connecticut basic EMTs can give intranasal Narcan, but only if their service is approved for BLS Narcan by their sponsor hospital.  That hasn’t happened yet for our service so no Narcan for Jerry.

And I stood there shaking my head because while as a paramedic I can clearly give...

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Ambulance: ECG Quiz

Written by RSS Poster Medic ScribeMedic Scribe

I found a great (And Free!) new web site for practicing ECG interpretation.

ECG Quiz

Check it out!



Ambulance: Intranasal Medication

Written by RSS Poster Medic ScribeMedic Scribe

One of the best innovations in EMS in recent years has been the introduction of intranasal medication through the use of an atomizer.  We currently carry three drugs that we can use intranasally.  These are Narcan, Fentanyl and Versed.

After several years of experience now with all of these drugs through the intranasal route, here are my impressions of the utility of each.

Narcan – I love intranasal Narcan.  I use it often and almost always for heroin overdoses.  It took a while for me to learn the patience required, but once I realized the patient would come around eventually (usually within 2-5 minutes, sometimes as long as 8-10), I stopped reaching for the IM Narcan and putting them into withdrawal with the IM Narcan added to the peaking IN Narcan. I have had conversation with many medics about this and each medic seems to have his preferred method.  Some like IV which gives you the ability to slowly titrate.  Some prefer IM for it fast action – the patient comes around sooner than the IV method  because the IV method...

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Ambulance: The Jug

Written by RSS Poster Medic ScribeMedic Scribe

There is a clear plastic jug — actually it is an empty water cooler bottle — that several times a year gets put on the table by the check-in window in operations. A handwritten note is attached asking for donations to help a fellow employee in need. A lot of money has gone into the jug over the years. Few professions know about hard times as much as ours. And we are not immune to them ourselves.

People in EMS don’t make a ton of money. That wasn’t why they went into this work or why they have stayed. Most need overtime or a second job to get by. And when hard times hit, few have the cushion to absorb them. That’s where the jug comes in. It is never enough, but at least it is something. A brother or sister in need. We see the jug and we reach for our pockets. A child with cancer. A bad accident that has laid someone up unable to work and with a long road to recovery. A sudden death. Over the years I have watched my fellow employees put their money in that jug. Maybe a $5, sometimes a crisp $20, others three or four loose...

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Ambulance: The Ideal Medic

Written by RSS Poster Medic ScribeMedic Scribe

I have been a full-time paramedic for over twenty years and a part-time hospital EMS coordinator for over six years. Over the years my ideas of who the best paramedic is have changed markedly. I used to think the best paramedic was the one with the swagger, the one without fear, who never hesitated to act, who never allowed doubt to enter the equation. And while I still admire many aspects of that paramedic archetype, from both my vantage of twenty plus years on the street and the newer position of someone who can actually match up what happens on the street (or at least as described in the prehospital run form) and what happens to the same patient in the hospital, I have learned that many paramedics I thought were never wrong, can actually be wrong quite often, and that some of the paramedics who I thought were rather dull, have actually pleasantly surprised me time and again.

So here is my new ideal medic(s):

A great medic will call a STEMI Alert even if he is not certain the patient is having a STEMI. He will never hesitate to call...

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Ambulance: AHA 2015 Guidelines- Guest Post

Written by RSS Poster Medic ScribeMedic Scribe

Hi-

I don’t have guest posts as a matter of course, but Anthony Randazzo,a paramedic from Knoxville, Tennesse offered to do one on the updates to the 2015 AHA guidelines, which we are all anxious to learn about, so I happily agreed. Take it away, Andrew

***

Back in January, Peter highlighted some of the upcoming guidelines for AHA. Today, Peter is letting me follow up with a post that will take a look at a few more changes and trends coming down the pike.

No More Vasopressin

This probably does not come as a shock to most of you. I don’t even remember the last time I used vasopressin. I think the only reason I’ve used it in a code is to say that I used it. Aside from the affects of the drug itself, it is very impractical. Typically you have to draw up 2 vials in order to get your 40 units, and it’s more time consuming than popping the caps on an amp of Epi and pushing them together.

Looking at the pharmacological effects of Vasopressin, statistics show that there is no superior benefit during cardiac arrest over using...

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Ambulance: The Butler Did It

Written by RSS Poster Medic ScribeMedic Scribe

There are any number of different ways to give a verbal handover report at the ED. All sorts of mnemonics. What form you use may depend on what your hospital expects. I try to tell a story. But I don’t tell a story in the same way I would write one. A written story takes you from point A to point Z with all the twists and turns, ending with the Da Dumm! The Butler Did it.

The other day I was listening to a new paramedic tell a triage nurse a great story of a very interesting call. Lots of the above mentioned twists and turns. It started with “We were called for…” It could just as well have started with “It was a dark and stormy night…” The problem was even though it was a great story the triage nurse was getting very impatient, not to mention she was interrupted by other nurses, doctors and her phone during the course of the medic’s novella.

My suggestion to the paramedic was when giving an EMS report to a triage nurse, you have to start with the last line. Begin with “The butler did it,” and then you can explain why you...

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Ambulance: Gifts

Written by RSS Poster Medic ScribeMedic Scribe

I just hit my 20 year mark with the company. For this, I received my choice of anniversary gift. You go to a link and they have various gifts you can get depending on which anniversary it is. 10 years ago, I got a set of Henkels knives. 5 years ago, I got a GPS which I gave to my now wife because she was always calling me asking for directions. She lost the GPS so it was a bit of a wasted gift. This time around I got another set of knives. While I got 13 the last time, this time I only got 7, but these are larger and a higher quality of knife. Included was a steel to sharpen the knives with and a pair of kitchen shears. The same set sells on Amazon for $299.95. If I make it to 25, I get an even fancier and higher quality set.

In my younger years I worked as a line cook for a year when I lived in Iowa. The Chef taught me the value of a good Chef’s knife. If there is only one knife you are going to get, it should be the Chef’s knife. You can cut, chop, slice, dice, whatever you need. It is a tool of the trade, what makes a craftsman a...

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Latest Medic ScribeMedic Scribe Stories

Lights and Sirens
Mirrors
Intranasal Narcan for All
ECG Quiz
Intranasal Medication

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Emergency Shorts:
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