Intranasal Narcan Approved

[Ga-Lin 86]

NYS SEMAC & SEMSCO has finally approved IN narcan for use by CFR's & EMT's. This still needs to be approved by the Commissioner of Health. Once approved protocols & educationl package will be developed & distributed. IN narcan was recently in the news being handed out to "high risk" general populace.

[SRS131EMTFF 471]

We just got intranasal narcan, BLS blood glucose and epi pen autoinjector in adults without a prexisting Rx in the new VT EMS protocols. New protocols were released tuesday and go live 1/1/14.

I am sure there are other cool things in the new VT protocols however I have not read it through completely yet.

[Goose 188]

Won't matter in westchester given the average bls ambulance response time. You're guaranteed an anoxic injury.

[Ga-Lin 86]

Maybe we should follow Conn.'s lead and distribute them to the general public. Like free needles

Edited October 10, 2013 by Ga-Lin

[SRS131EMTFF 471]

Maybe we should follow Conn.'s lead and distribute them to the general public. Like free needles

We do that in VT too. The legislators made it legal to give to the public to prevent overdoses so the VT DOH EMS said if junkies can't F* it up then neither can CFRs, thus intranasal narcan is a CFR level skill in our new protocols.

[RNEMT26 40]

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Edited October 11, 2013 by RNEMT26

[x635 4,066]

I agree with the comments that they should be given to the public, with no questions asked. Especially with the heroin that's been going around. I remember, I believe it was Baltimore, several years ago they had a pilot program for addicts to give Narcan IV directly via needle. After all, they didn't need training on how to find a vein.

I also think that Police Officers who receive training should also be able to administer IN Narcan. They are often the very first on scene in a few communities.

The only risk I see is the potential for violence of the patient when the high is reversed. Although I haven't seen that happen too much, there should be emphasis that there be no weapons nearby, and other safety measures.

[Ladder44 73]

Here's a fun little question, even tho I'm sure whoever answers it will probably just goggle it.

- So what if you have someone who decided to take an over dose of tramadol (Ultram) What do you do? Tramadol is NOT an opioid.

What we've always done, BVM....

[v85 212]

I agree with the comments that they should be given to the public, with no questions asked. Especially with the heroin that's been going around. I remember, I believe it was Baltimore, several years ago they had a pilot program for addicts to give Narcan IV directly via needle. After all, they didn't need training on how to find a vein.

I also think that Police Officers who receive training should also be able to administer IN Narcan. They are often the very first on scene in a few communities.

The only risk I see is the potential for violence of the patient when the high is reversed. Although I haven't seen that happen too much, there should be emphasis that there be no weapons nearby, and other safety measures.

That's why you should give Narcan slowly, and only enough to get them breathing on their own regularly.

[sympathomedic 383]

I thought Suffolk County NY and I am sure State of Massachusetts PD's are using IN Narcan with much success? Maybe it is Suffolk Mass I am hearing of. Guess tht famous scene from "Bringing out the dead" will soon be obsolete!!

http://www.youtube.com/watch?v=CXJ8c0rWJsk here it is for you kids- worked with a 23 year old medic last week who never heard of the movie! Christ!!

[Goose 188]

Here's a fun little question, even tho I'm sure whoever answers it will probably just goggle it.

- So what if you have someone who decided to take an over dose of tramadol (Ultram) What do you do? Tramadol is NOT an opioid.

When did tramadol stop being an opioid?

And yes, i did look it up because i've never read/heard/have been told its not an opioid (the serotonin effects are kinda of cool to read about though)

http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=cabccc8a-6f9f-414c-93f0-6dec331ed74b

Edited October 10, 2013 by Goose

[x1243 141]

While I can not find it, Phoneix started a pilot on the Intranasal Narcan. The numbers were actually astounding. The revival or success rate was near 97%. Getting there in a timely manner hopefully your only findings are respiratory arrest, thats where the good old BVM and Narcan would be huge.

Obviously we know when bad batches come into our jurisdictions, the OD calls rise.

I think this would be a asset on a BLS level.

Be safe everyone......

[50-65 205]

I guess maybe I'm just getting old and cold. You want to shoot up and OD, well that's the chance you take. It may be a cool new toy to play with, but its my ever increasing tax dollars at work. Save 'em so we can save 'em again next weekend. Eventually you just need to let Darwin do his work.

[medic84r4ny 2]

i agree with 50-65. Let them die they are just another leach on society and thier own families. May be if enough of them die kids will get the message, as well as saving Tax payers millions....

[x635 4,066]

Some of the above comments sicken me. Our job and duty is to save lives, not to judge and decide who is deserving of our care. Just because someone is addicted to drugs does not make them any less of a human being, and any less worthy of our care.

[ARI1220 12]

I agree with x635. Addiction is horrible and dying is certainly not the answer. The 21 year old who shoots up most likely doesn't have the intentions of OD'ing. However, should he or she OD, having nasal narcan can get that person back under bls care while ALS is enroute. This was an excellent post, but too see such pathetic ignorance is disgusting.

[Ga-Lin 86]

You really can't go down this road, once begun where does it stop. Should we stop treating cancer patients, how about not resus anyone over 80, or how about 75. No, better as health care providers to treat everyone. Lfie is presious, some people do turn thier life completly around and become "useful members of society.

Edited October 12, 2013 by Ga-Lin

[wiscems 23]

Some of the above comments sicken me. Our job and duty is to save lives, not to judge and decide who is deserving of our care. Just because someone is addicted to drugs does not make them any less of a human being, and any less worthy of our care.

I agree, regardless of your personal feelings towards someone's lifestyle, we don't go screaming through the city lights and sirens to arrive on scene and judge someone...

[50-65 205]

I'm not saying I scream to a scene lights and sirens only to judge. Actually, I've been accused of driving too slowly to a scene and often respond without l&s. And I'm not saying that once on scene I wouldn't treat a pt without using all the tools available to me. You have made those assumptions.

[INIT915 1,119]

I guess maybe I'm just getting old and cold. You want to shoot up and OD, well that's the chance you take. It may be a cool new toy to play with, but its my ever increasing tax dollars at work. Save 'em so we can save 'em again next weekend. Eventually you just need to let Darwin do his work.

Wow. Have a problem with treating diabetics because they eat too much? What about cancer patients, since it might be related to unhealthy lifestyle choices? Is this your personal prerogative or an agency policy?

[SRS131EMTFF 471]

I'm not saying I scream to a scene lights and sirens only to judge. Actually, I've been accused of driving too slowly to a scene and often respond without l&s. And I'm not saying that once on scene I wouldn't treat a pt without using all the tools available to me. You have made those assumptions.

So what are you advocating for with your precious tax dollars? How exactly would you "let darwin do his work"?

[50-65 205]

Wow. Have a problem with treating diabetics because they eat too much? What about cancer patients, since it might be related to unhealthy lifestyle choices? Is this your personal prerogative or an agency policy?

A suspect shoots and kills two of your co-workers and you are pursuing him. He crashes, is critically injured and no longer a threat.. Are you going to do everything you can, including c-spine, to possibly save his life or pull him from the wreck and handcuff him?

Edited October 13, 2013 by 50-65

[INIT915 1,119]

A suspect shoots and kills two of your co-workers and you are pursuing him. He crashes, is critically injured and no longer a threat.. Are you going to do everything you can, including c-spine, to possibly save his life or pull him from the wreck and handcuff him?

Well, based on your argument (and supported by your Tea Party Avatar), I'd have to consider the possibilities that my taxes are impacted. Pathetic.

Makes me wonder about your commitment to your patients well being. Do you take it a step further? Do you make treatment decisions about certain groups of people you don't care for as well? Maybe based on race or religion too? Or is it just groups you feel are inferior? Someone should contact your employer. Your PCR's should be QA/QI'd to identify any cases where your personal feelings have dictated patient treatment based on your distaste of them or where you thought they might cost too much.

[SRS131EMTFF 471]

A suspect shoots and kills two of your co-workers and you are pursuing him. He crashes, is critically injured and no longer a threat.. Are you going to do everything you can, including c-spine, to possibly save his life or pull him from the wreck and handcuff him?

You still have not answered my, or anyone else's, question.

[Ga-Lin 86]

A suspect shoots and kills two of your co-workers and you are pursuing him. He crashes, is critically injured and no longer a threat.. Are you going to do everything you can, including c-spine, to possibly save his life or pull him from the wreck and handcuff him?

I would guess the ans. depends on how you view yourself, primarily. As a LEO or HCP (health care provider) As a stickly LEO I can understand the reason for pursuit & also cuffing a suspect ASAP. I've watched those real life police chases where after the suspect has a spectacular crash the officer actually risk their lives to pull him from a burning vehicle (which he stole) only to have the perp ,as soon as his feet hit the pavement, take off like a gazelle across the Serengeti with a lion in hot pursuit. As a HCP I cannot see myself pursuing anyone in my ambulance or fly car. Although I did once, more years ago than I care to admit. An old time NYPD Sgt. gently took me aside & asked what I was thinking. what was I going to do if & when I caught him. what if he had a weapon. He had seen me work on various calls prior.to this & told me "kid we all have our jobs to do & you seem to know & do yours well, let us do ours." Your point of view got me thinking about another issue to post.

[velcroMedic1987 330]

Well, based on your argument (and supported by your Tea Party Avatar), I'd have to consider the possibilities that my taxes are impacted. Pathetic.

Makes me wonder about your commitment to your patients well being. Do you take it a step further? Do you make treatment decisions about certain groups of people you don't care for as well? Maybe based on race or religion too? Or is it just groups you feel are inferior? Someone should contact your employer. Your PCR's should be QA/QI'd to identify any cases where your personal feelings have dictated patient treatment based on your distaste of them or where you thought they might cost too much.

Hey, don't knock the avatar. That flag long predates the contemporary tea party.

[velcroMedic1987 330]

A suspect shoots and kills two of your co-workers and you are pursuing him. He crashes, is critically injured and no longer a threat.. Are you going to do everything you can, including c-spine, to possibly save his life or pull him from the wreck and handcuff him?

I'm just guessing that it will depend on department policy, access to the victim, and the perceived threat. If he is a potential threat, he should be handcuffed before we get there so we don't get injured by him.

This is a completely different scenario too! You changed the focus because you didn't like people calling you out for being a judgmental ass in your earlier post. The Darwin comment suggests only one thing; that an overdose victim is lower on the evolutoinary scale and not worthy of our efforts. Deflect all you want, that's what you implied.

[Bnechis 3,961]

I guess maybe I'm just getting old and cold. You want to shoot up and OD, well that's the chance you take. It may be a cool new toy to play with, but its my ever increasing tax dollars at work. Save 'em so we can save 'em again next weekend. Eventually you just need to let Darwin do his work.

The Darwin comment suggests only one thing; that an overdose victim is lower on the evolutoinary scale and not worthy of our efforts. Deflect all you want, that's what you implied.

Interesting, because I took it not as lower on the evolutionary scale and more as thinning the heard/survival of the fitest. If you are dumb enough to think you can put anything into your body without consiquences than you may find you will not live a long life.

I have 2 problems with this:

1) staffed BLS units should get this, but as previously stated you are unlikely to get BLS in Westchester onscene in time to use it,

2) giving it out to junkies so they can us it themselves, why not also pay for their narcotics as its their "medication"? We spend billions on the war on drugs (another issue) and this just sends a message that if you want to shoot up for the 1st time to see if you like it, its safe because your buddy can stand by and save you and no one will get caught.

[50-65 205]

Final thoughts on this and my apologies to the OP for the direction some, including myself, have taken this thread.

1. Not a member of the "tea party".

2. The "thinning the herd" comment was more what I was thinking.

3. ANY LEO or HCP here, that say they don't judge a suspect or patient in some way is a liar. We ALL do it, whether you want to admit it or not. Are you honestly going to say that you haven't judged, in some way, the EDP that you have responded to the 15th time? The drunk that wrecked his car? The frequent flyer? The homeless alcoholic? The "seeker"? The nursing home? Do you see the elderly white lady driving the Buick the same as you do the middle aged black man driving the Mercedes? Would it make a difference if that white lady were in the grocery store parking lot and the black man was in your neighborhood or "the hood"?

We ALL judge. Yet rather than admit it, you would rather crucify me here because I admit that I don't have the same level of "compassion" for the addict as I might for someone else.

Look in the mirror ladies and gentlemen.

[INIT915 1,119]

Hey, don't knock the avatar. That flag long predates the contemporary tea party.

Yeah, but when you couple it with the context, you don't need to be a rocket scientist.