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Ambulance: Naloxone and Cardiac Arrest: New Scientific Paper from AHA

Written by RSS Poster Medic Scribe

In 2010, the American Heart Association wrote “naloxone has no role in the management of cardiac arrest.”  This came as a surprise to many medics who routinely gave naloxone to cardiac arrests patients suspected of opioid overdoses, and may come as a surprise to many medics who continue this practice.

The idea against using naloxone is fairly simple.  If the opioid overdose caused the cardiac arrest, the cause of death is hypoxia.  Naloxone can reverse apnea in patients who are still alive, but naloxone cannot undo a hypoxic death.  Patients in cardiac arrest from opioid overdoses need to get their hearts started with epinephrine.  All naloxone can do is put the patient in withdrawal should their be resuscitated with ACLS drugs.  What about ventilation?  That’s what ambu-bags are for.

In their new March 2021 paper, Opioid-Associated Out-of-Hospital Cardiac Arrest: Distinctive Clinical Features and Implications for Health Care and Public Responses: A Scientific Statement From the...

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Ambulance: Think About Mama

Written by RSS Poster StorytellERdoc
 "If you think a mother's pain is unimaginable, you should see her strength."

You were visiting your mother when, while in another room, you became unresponsive and fell to the floor. She heard the thump of your fall and raced into the room to find you pale and barely breathing. Drug paraphernalia sat beside you.

Your mother screamed. She cried. She fell to her knees and tried to wake you, slapping your cheek and compressing your chest and forcing her own breath into your mouth. You did not respond.

Your mother frantically called 911. Within minutes, the paramedics arrived. With quick and concise care, they administered several large doses of Narcan to you. Within seconds, you began to cough and gag before finally taking a deep breath. Your eyes fluttered and then finally opened. In your daze, you saw your mother's heartbroken eyes staring back at you. Her prayers were answered.

You survived.

In the ER, I was your doctor. I interviewed both you and your mother and learned what had just happened at her house. I learned that you...

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Ambulance: Men With Guns

Written by RSS Poster Medic Scribe

I was a new paramedic.  The senior medic briefed me.  They took two guys out of a basement apartment with high carbon monoxide readings after a dryer caught on fire.  Ones already on the way to the hospital for evaluation. Your patient is the guy over by the building door arguing with the police officer.  He wants to go back in his apartment to get some items, and the officer won’t let him.  Just then the man punched the officer in the jaw..  The officer threw the man against a car and put him in a headlock, and then handcuffed him.  Instead of bringing him over to us to be evaluated, the officer put him into a squad car.  “Asshole!” he shouted at the man.

“Do you think he’s an asshole or do you think maybe carbon monoxide is making him act like an asshole?” I said to the other medic.  “Shouldn’t we go over there and talk to him?”

The medic shrugged, and said, “You can’t argue with a man with a gun.”

The cop took him to the police station for booking and we cleared the scene “Patient item A...

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Ambulance: Bare Your Arms, My Country

Written by RSS Poster Medic Scribe

It’s back.

Two weeks ago, our hospital had 0 COVID patients admitted down from highs of 55 in April and 44 in December.  Just like that we are back up to 12 in just a couple days.  Elsewhere in Connecticut, the head coach of the woman’s top ranked basketball team missed the opening round of the NCAA tournament with COVID.  Some girls my daughter plays basketball with had to quarantine due to exposure to people with COVID and on the COVID ACT Now, map, Connecticut has again turned red, signifying.

From all I have read, the cause is likely the arrival of the COVID variants that are more infectious than the original COVID.  We are all hoping that our high and ever increasing vaccination rate (33% 1st dose/18.6% fully vaccinated) will soon overcome the variants, but we can’t be certain.

Daily coronavirus updates: COVID-19 hospitalizations rising in Connecticut as variants spread; vaccine distribution skewed toward white residents

I am worried about the number of people who are still refusing to get vaccinated.  It was a huge relief for me to get my shots, and I hope others will soon make the decision to bare their arms for their country.



Ambulance: Podcast-Saving Lives and Learning a Lesson About Addiction

Written by RSS Poster Medic Scribe

Just out, an interview I did with the Addiction Podcast about my new book, Killing Season; A Paramedic’s Dispatches from the Front Lines of the Opioid Epidemic.

Peter Canning – Saving Lives as a Paramedic and Learning A Lesson About Drug Addiction



Ambulance: Killing Season – 30% Off with Code

Written by RSS Poster Medic Scribe



Ambulance: Opioid Epidemic/COVID Interview

Written by RSS Poster Medic Scribe

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Ambulance: Two Reasons

Written by RSS Poster Medic Scribe

By all accounts, the opioid overdose epidemic is getting worse.  A recent study published in JAMA which analyzed emergency department visits (ED) found overdoses were up 29% from March to October of 2020 versus the same period for the previous year.  In Connecticut, the medical examiner’s office has found 1259 people have died of overdose compared with 1200 in 2019, with an additional cases still pending test results.

Opioid overdoses 29% higher in 2020 than before the pandemic: Study

Fatal Unintentional Drug Overdose Report Key Findings of Drug Overdose Decedents, 2019 – January 2021

Connecticut has released its final numbers for 2020.  Overdose deaths reached a new high -1374, up 14.6% from the previous year.

Connecticut Accidental Drug Intoxication Deaths Office of the Chief Medical Examiner

If we want to decrease opioid overdose deaths, we have to understand why people die from these deaths, and then take bold steps to address those causes.

As a paramedic who has responded to opioid overdoses with increasing frequency over the...

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Ambulance: Killing Season: Coming April 6

Written by RSS Poster Medic Scribe

 

I have had some great publicity for my forthcoming book lately.

Here is a interview with the Hartford Courant:

Paramedic chronicles the daily tragedy of drug overdoses in Connecticut before and during pandemic

The story was picked up by other papers across the country.

I also received a great review in EMS World from Mike Rubin:

Book Review: Killing Season

Here are some of the other advance reviews for the book:

 

 

“Full of engaging stories. Only someone on the front lines of the crisis, like an EMT, could describe overdose situations and the people who have overdoses with such color.”

— Barbara Andraka-Christou, University of Central Florida, author of The Opioid Fix: America’s Addiction Crisis and the Solution They Don’t Want You to Have

“With crisp and propulsive storytelling, Peter Canning chronicles his evolution as a paramedic during the most lethal drug crisis in history. As a rookie, Canning initially regards opioid users as ‘scumbags’ but eventually finds empathy for the victims of this...

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Ambulance: Wild Rescues

Written by RSS Poster Medic Scribe

I just finished Wild Rescues: A Paramedic’s Extreme Adventures in Yosemite, Yellowstone, and Grand Teton by paramedic Kevin Grange.

Kevin Grange is an excellent writer and Wild Rescues is great book that delivers on its promise.    From the moment he drives up to Yosemite in a snowstorm to start his job as a ranger paramedic to his responding to a search and rescue for a missing and badly injured hiker in the Gran Tetons, it is as if you are there with him, gradually becoming more confident in your demanding job, taking in the glory of El Capitan, keeping a watchful eyes on the grizzly bears, and learning the fundamentals of  wilderness medicine.   Grange has an easy going narrative style aimed at the common reader while still having the medical depth that will appeal to emergency medical services professionals.  I now understand the unique challenges of wilderness medicine, where the extrication plan is as big a part of the patient’s treatment as the hands on medical care.  I have never been to Yosemite, Yellowstone or Gran...

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