Paramedic: On the Front Lines of Medicine

Paramedic: On the Front Lines of Medicine

by Peter Canning

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Overview

In this unforgettable, dramatic account of one man's experience as an EMT, Peter Canning relives the nerve-racking seconds that can mean the difference between a patient's death and survival, as Canning struggles to make the right call, dispense the right medication, or keep a patient's heart beating long enough to reach the hospital. As Canning tells his graphic, gripping war stories--of the lives he saved and lost; of the fear, the nightmares, and the constant adrenaline-pumping thrill of action--we come away with an unforgettable portrait of what it means to be a hero.

Product Details

ISBN-13: 9780307558930
Publisher: Random House Publishing Group
Publication date: 02/04/2009
Sold by: Random House
Format: NOOK Book
Pages: 368
Sales rank: 283,848
File size: 2 MB

About the Author

Peter Canning is a full-time paramedic in Hartford, Connecticut. In addition to his government jobs, he has worked as a cabdriver, cook, meatpacker, telephone solicitor, book reviewer, and laborer. A graduate of the Iowa Writers Workshop, Canning is currently at work on a novel about EMS.

Read an Excerpt

The City
 
I head south on Interstate 91 (I-91) on this January morning. It is a drive I have made many times over the years, first as a child coming to the city from the suburbs to visit my father at his office in Constitution Plaza. He’d take me shopping at G. Fox, Korvette’s, and Herb’s Sports Shop, and then to dinner at Honess’s, where we would eat bluefish and steamed clams, or to Valle’s for steaks. Later I drove to work myself, parking on the capitol grounds and entering that grand building on the hill with the gold dome where I worked for the governor. From the distance, above the countryside, Hartford’s skyline rises as impressive as the Land of Oz or the metropolis protected by Superman. I used to think of the city as a symbol of all that was good with America—progress, jobs. Yet I knew for all the light, there were also shadows. In 1968 when I was ten, the north end of the city was racked with riots in the wake of the assassination of Martin Luther King, Jr. One morning our biweekly cleaning woman who came from Hartford got out of her car, drunk and shouting that she wouldn’t get on her knees “to clean no floors for no white woman.” One year a coworker of my father’s had a bullet pierce a window of his station wagon on his commute to work, forcing my father and others to start using an alternate route. In later years working for Senator, then Governor Weicker, I accompanied him into the city’s poorer areas and saw the poverty through the windshield of our escorted car. And I researched and wrote the speeches, the ones that cited the fact that Hartford, despite being the capital of one of the wealthiest states in the union, was one of the country’s ten poorest cities, that its infant mortality rate rivaled that of third-world nations, that its schools were segregated and failed miserably to provide their students with equal educational opportunity.
 
In recent years, in Shakespeare’s words, “sorrows” have come to Hartford, not as “single spies, but in battalions.” The city’s manufacturing base, which fueled its growth for nearly a century, is gone. The insurance companies and financial institutions that are at the city’s heart have undergone mergers, major downsizing, and layoffs. Long-standing stores and restaurants, like some of the ones my father took me to, have closed their doors forever. As the city’s tax base has eroded, the number of those needing assistance has risen dramatically. Crime, poverty, unemployment, homelessness, AIDS, and other diseases are at epidemic levels. Today Hartford’s population—its lowest since World War I—is predominantly black and Hispanic. The blacks live largely in the north end along North Main Street and Albany Avenue in crumbling private homes and apartment buildings and in notorious public housing projects like Bellevue Square and Stowe Village, centers of a thriving illegal drug trade. The south end, which still houses old Italian families, is increasingly Hispanic. And while there are still mansions in the west end, most of the city’s well-to-do residents have fled over the years to the affluent suburbs like West Hartford, Newington, and Simsbury, the town I grew up in. While Hartford was once a bastion of Protestant Yankees, today only 5 percent of its schoolchildren are Caucasian.
 
Interstate 91 intersects with I-84 on the raised highway east of the city. I follow I-84 west, going through a short aboveground tunnel with its “Welcome to Hartford” message embedded in concrete. The road twists, turns, and rises above the streets. Below are empty factories with broken windows and deserted parking lots with grass sprouting through the cracks in the asphalt. I take the Flatbush Avenue exit and then turn on Newfield just before the railroad tracks. On the left is the Charter Oak public housing project, a collection of small two-story units with rusted bars on the outside windows, a scene of gang warfare, drug trafficking, and several of the city’s record fifty-eight homicides in 1994. As in other areas of the city, here a car can be forgiven for not stopping at a red light.
 
I turn onto New Britain Avenue, passing check-cashing stores, garages, gas stations, doughnut shops. A few blocks away, just across the city line into West Hartford, are the offices and cavernous garage of the Professional Group, the home of Professional, L&M, Maple Hill, and Trinity ambulances. At this hour, young EMTs and paramedics go about checking their ambulances. They stock them with spare oxygen tanks, bandages, IV solutions, and long backboards. Others undo their bullet-proof vests and punch out after a long night of battling disease and violence on the city’s streets.
 
I wish it were not my first morning. I wish that I had been working here for years, and that on walking into the garage and into the supervisor’s office, people will hail me by name and think, “It’s Peter Canning. He is a grizzled veteran, a great, proven paramedic. I would trust him with my life.” Few of them know me. I am a rookie with much to prove.
 
Checklist
 
The fundamental idea behind EMS is to commence medical treatment for injured and sick patients as early as possible—to bring the hospital to the patient at the same time the patient is being brought to the hospital. In the old days, the person who responded with the ambulance put the patient in back, got in front, and drove like hell to the hospital. (He often was the same person who drove the hearse the next day.) Today there are two main levels of prehospital care: basic and paramedic. The paramedic, the most highly trained, provides advanced life support—complex assessment and treatment including invasive procedures and the administration of drugs under the direction of an emergency medical physician both through standing orders and direct communication. The worst insult that can be hurled at an EMT or paramedic is to call him an ambulance driver. They are medical professionals, subject to continual education, testing, and medical oversight.
 
Meg Domina will be my partner on Wednesdays. A nice freckled twenty-five-year-old paramedic, she has been working in the city for five years. With Meg I will function as a basic-level partner to her paramedic, though I will be able to use my paramedic skills if needed. On Thursdays and Fridays, Tom Harper will be my partner and preceptor. After thirty paramedic calls Tom will either recommend me for medical control to work as a paramedic with a basic partner or say I don’t make the grade, in which case I will be able to work only as a basic EMT. I do have a little bit of an inside advantage. When I volunteered as a paramedic in Bloomfield I worked with Michelle Gordon, who precepted Meg years ago, and had worked with Tom in the city back when he was just a basic EMT assigned to the city. I go out with her now, so she has put in a good word for me with them. While I do not like using a crutch such as this, I will take every advantage I can get. I am rusty, haven’t worked for the company before, and have a lot to learn from how to work the radios to how to be a good paramedic.
 
Meg gives me a warm good morning, then tells me to check out the rig, while she gets us radios. The ambulance is a van type, smaller than the large box ambulances favored by most volunteer corps, who carry crews of up to four people. The van ambulance is built for twenty-four-hour, seven-day-a-week abuse. In the back there is room for a stretcher tight against one wall, and a bench seat against the other with about a foot of room in between. At the head of the stretcher is another seat where a rider can sit, facing the patient’s head. It is the preferred seat to manage a patient’s breathing. Under the bench seat are two longboards for spinal immobilization, a metal scoop stretcher that comes apart in the middle and is used to fit under somebody who needs to be lifted up but doesn’t need spinal immobilization, a traction splint for isolated femur fractures, a Kendrick Extrication Device (KED) to help stabilize the spine of someone trapped in a car, a urinal, and a bedpan. By the back door on the stretcher side is the collapsible stair chair for carrying patients down from the second, third, and hopefully not much above the fourth floor, and a wooden short board. The cabinets on the stretcher wall are filled with linen, cervical collars, IV supplies, trauma dressings, bandages, oxygen masks, and cannulas (a plastic tube with two prongs that fit under the patient’s nose to give them a richer oxygen to breathe than what exists in room air). At the head is the oxygen outlet and in-house suction unit. By the side door is a rack that holds the cardiac monitor, the pediatric box, and three spare portable oxygen cylinders. The portable suction is on the inside of the door. It is used to clear mucus, blood, or vomit from a patient’s mouth and throat. The cabinet between the back and the driver’s compartment holds the military antishock trouser (MAST) pants, a spare advanced life support (ALS) supply box, and run forms, on which we document our treatment of each patient. The main gear we take into the house in addition to the monitor includes the blue in-house bag, the airway kit, and the biotech.
 
The in-house bag has a portable oxygen cylinder, airway supplies, blood pressure (BP) cuff, obstetrics (OB) kit, burn sheets, trauma dressings, ammonia inhalants, and spare run forms. The airway kit holds the laryngoscope, and the various sized and shaped metal blades that attach to the handle. The blades have tiny lightbulbs on the end that illuminate the patient’s throat as you search for the vocal cords through which you will pass a clear plastic endotracheal tube that again comes in various sizes—from a tube for the tiniest baby to the Andre-the-Giant-sized ten tube. The biotech is a hard black suitcase that holds the emergency drugs and IV supplies, except for morphine and Valium, which are kept above the monitor shelf in a lockbox. The heart monitor displays the patient’s electrocardiogram (EKG) on a small two-inch screen when attached to the patient through three wire leads—the white lead on the upper right chest, the black lead on the upper left, and the red on the lower left side. “White is right, smoke over fire,” I say to myself to keep the order straight. The monitor also has detachable paddles, which when applied to the patient’s chest and activated can deliver an electric shock of up to 360 joules (Js) to a patient’s fibrillating heart in hopes of stopping it cold, so it can hopefully restart by itself with its normal rhythm. The newer models have hands-off pads that can be applied to the chest, one on the right sternum, the other on the left apex, so the shock can be delivered without having to be in such close contact with the person.

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Paramedic 4.5 out of 5 based on 0 ratings. 28 reviews.
ladycato on LibraryThing More than 1 year ago
I read the sequel to Paramedic about two months ago, and this first book is much of the same. This is part of my continued research for my novel. I've been reading so much about EMS that it's starting to creep into my dreams.Peter Canning was a speechwriter with powerful connections throughout the northeast and Washington D.C. However, he gave up his big paycheck and nice office to go and work on the streets of Hartford, Connecticut, as a paramedic. He sees many of the same drunks day to day, is frustrated with the system, and every now and then makes a big save that makes everything worthwhile. For my selfish purposes, I wish he had gone into more details about some of the mundane details of dispatches and paperwork, but it still provides me with many ideas.
Anonymous More than 1 year ago
Anonymous More than 1 year ago
Great book! Very true to real life EMS. I liked this one better than the first book!
Anonymous More than 1 year ago
Paramedic by Peter Canning follows his transition from the boring day to day live behind a desk, to the ever changing world that is a paramedic. Through the six month journey that this book is based, Peter learns to think on his feet and deal with a variety of trauma, disease, and death that is in the everyday life of a paramedic. Through literally blood and sweat, he learns to balance his job with his social life, and he learns to follow truly what he enjoys, and that money and a position of power do not equate to happiness. This is a fantastic book which provides excellent insight into the world of another. This book is based more during the 1990’s, where AIDS, racism, and general misinformation about illnesses run rampant. Peter Canning has a fantastic writing style which makes this book a very easy read. It was very difficult to put down, and it truly opened my eyes into what it takes to be a paramedic, and truly how completely unique their jobs and lives are. One thing that I did not like about the book, is that with any job, it becomes a little bit routine towards the end. However, when alcoholics and heart attacks are put of your daily job, it is still very easy to stay intrigued with the book. This book would be a very good read for anyone, especially if there looking into how paramedics operate, and what it takes to be one. This book would greatly benefit any upcoming paramedics, or anyone looking to see how another job operates, especially under incredible stress. Another book I would strongly recommend is Paramedic to the Prince by Patrick Notestine. Based on the incredible writing style, and the fantastic subject of being a paramedic, this book easily earns, and deserves a five out of five.
Anonymous More than 1 year ago
I read this book as a new EMT and couldn't put it down. As a Paramedic now, I continue to search for a realistic EMS account that draws me in as much as this one.
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EMTerry1 More than 1 year ago
As a lowly EMT-B working for a Volunteer Fire Department out in the boonies, I really found a lot to recommend in this book. Not only easily readable, humorous, and spot on, this book really gave me some insight to the inner workings of the mind of a SuperMedic. Seriously, the book presents several examples of the types of "calls" EMS personnel see all to frequently. I found the insight of how these calls were handled helpful in how I will react when I roll on something similar. I have already bought Peter Cannings other works and am looking forward to reading them. I believe you will find them good reads as well.
Anonymous More than 1 year ago
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John Spencer More than 1 year ago
i have not read the ebook but rather the paperback before ereaders came along. any errors are definitely an upload issue as Peters writting is brilliant. this book brings you to the days of medics walking the streets as a brand new level of care and their amazing heroics and tales. a great read for anyone in ems!
Anonymous More than 1 year ago
Anonymous More than 1 year ago
I work as a BLS (Basic Life Support) provider, for 4 years now; I have responded on several injuries both severe and non-severe. Therefore, I must say, I love this book. It is a tale of both despair and excitement. You will go on a sad and joyous journey of a young pre-politician turned paramedic as he responds to calls that will make him question the very life he was given in the Hartford, Connecticut area. Some of his anecdotes are harrowing and emotional when he deals with death, but the few times he makes a save will be heartwarming and uplifting. Peter Canning starts out as a politician's aid that has had enough of the boring office life and wants to truly make a change for his city, so he signs up and trains to be part of the EMS (Emergency Medical Service). He often makes mistakes in his first couple of years in training, but eventually he learns how to be a better ALS (Advanced Life Support) provider, and a more sincere person in general. There are calls that question the moral fabric of the government's medical care and even the EMS protocol itself, it is an underlying message that shows it's face throughout the book. A theme that remains static through the novel was the emotional stress that is put on the individuals who decide to join this career. Since I am involved in BLS, I liked all the medical jargon, and even learned a few things from the text. I also like the voice that Peter Canning uses in his writing, I have yet to read his next novel but I assure you that I will. The parts I didn't like were when he went into detail about his previous career working for the politician, but these parts were necessary to the storyline, they just got kind of, frankly put, boring. Anyone who is part of EMS or even knows basic CPR will most likely enjoy this book because it delves deeper into the mind when it is responding to an emergency, and you will pick up on some very important signs and symptoms of the patients that he writes about, that normal people would ignore, which I thought was really cool. I think people would most likely not like this book would be the folks that are not medically trained; there is jargon that they would not understand and things that they have not dealt with so they would not really get the significance, but it is full of action so maybe they would like it after all. I don't know any other books like this that show, in detail, what anybody in the medical field goes through. This book is very unique in that respect, so I really could not tell what book to go read next for those that liked it. Rescue 471 would be the closest thing because it is written by Peter Canning.
Anonymous More than 1 year ago
If you love the job, you'll love and appreciate this book. You can relate to all the events and really get into it. If you are not in the medical field at all, you will understand more about what we grow through everyday.
Anonymous More than 1 year ago
Guest More than 1 year ago
An amazing story, I have grown up with paramedics as parents but they would never tell me the grit and grind of the streets, I am glad I was able to read this book as I was studying to take my own first steps into the world of Emergency medicine
Guest More than 1 year ago
I am currently and emt-b student after reading this book i feel ive made the right choice. Truely inspiring
Guest More than 1 year ago
This book is an amazing look into the world of paramedics. Canning takes the reader from his desk in Washington D.C. to his EMT-B trainting and on to the streets and EMT-P training.
Guest More than 1 year ago
Mr. Canning has been able to show what it is really like to be a street medic. Many of his interactions with the patients and families made me recall some of my calls. As with him some were happy and some were sad. If you are thinking of starting a career in EMS or have been in it for years this book is well worth the read.
Guest More than 1 year ago
This book is wonderful at illustrating the emotional rollercoaster of living an EMS life. It is the career story of one person as he goes from writing speeches for a senator-turned-governor from a part-time minimum wage making EMT-B to a full-time EMT-P. As such, I find that this book serves as a good career road map for new paramedics and EMTs. It shows them that they arent the first person to ever have to work amidst red tape as well as giving them a personalized picture of how one man deals with the ghosts and the nightmares. I have recommended it to many of students and new employees that I have precepted and I have been thanked numerous times for opening that door for them. Canning is an excellent writer and has a gift, not only for putting his emotions on paper, but for making you feel them as well.
Guest More than 1 year ago
Very well written , and a truly inspiring story.
Guest More than 1 year ago
This book is a captivating look at one mans' desicion to change his life. The stories of joy, loss, and unexplainable.
Guest More than 1 year ago
Peter Canning writes a spellbinding chronicle of the EMS profession. From the part about shocking a live patient, to the ho hum transports, the book tells the truth about the profession. Can't wait for the next one to come out.