Westchester to provide first responders with lifesaving Narcan

[x635 4,066]

This has been discussed many times on this forum over the years, especially lately.

Does anyone know how Westchester is going to implement this plan? Does this have to go through WCREMSCO? And will it be Police, Fire, and EMS? And when will this start? I'm glad this is finally going to happen, and know it will save lives.

WHITE PLAINS – Westchester County is the latest local government in the Hudson Valley that is going to equip first responders with Narcan, a life-saving drug that can revive drug overdose victims.

Source: http://www.midhudsonnews.com/News/2014/May/07/WC_Narcan-07May14.html

[velcroMedic1987 330]

Where's the program to make sure heart attack or stroke victims (or any other taxpayer suffering from illness or injury) get an ambulance in Westchester in a timely fashion?

Heroin overdoses resulting in respiratory depression account for what percentage of calls? 1/10 of 1/10 of 1%?

What percentage of calls have a delayed response because a VAC can't get a crew out or a commercial company has all its units running? 30-40%?

This is a bandaid on someone in multi-systems trauma. The EMS system is broken but we won't address that.

[GBFD111 73]

I have heard that many VAC's in Westchester already have completed their in-service training for Nasal Narcan and already have it. I would rather BLS crews have Glucagon over the Narcan. BLS providers can use Glucometers though cannot give glucose to unresponsive patients. During a Diabetic Emergency minutes DO matter and if all of the Medics are out on a job we can't give D-50 the VAC's are stuck. Lets try to save those who have an actual medical emergency instead those who overdose on narcotics.

[Bnechis 3,961]

Narcan does no good if its being paged 2 or 3 times and then goes mutual aid. And I want to see BVM's for OD before narcan.

What is really behind all of this?

One law enforcement supervisor told me that he was at a recent "conference" on Narcan for law enforcement that was sponsored by Amphastar Pharmaceuticals (the only manufacturer of Narcan).

What a shock. Anyone notice that in the last 7 years the price of the drug has doubled?

In a recent article; "Amphastar says it is not able to discuss its pricing history for competitive reasons."

What competitive reasons, as they have a monopoly?

[16fire5 693]

Narcan does no good if its being paged 2 or 3 times and then goes mutual aid. And I want to see BVM's for OD before narcan.

Can't agree more about the BVM. It really bothers me that we'll have some police agencies who won't do CPR on grandma but are going to administer narcan to iv drug users.

[Ga-Lin 86]

Can't agree more about the BVM. It really bothers me that we'll have some police agencies who won't do CPR on grandma but are going to administer narcan to iv drug users.

Doing CPR for 20-30 minutes waiting for an ambulance (paged out 3-4 times & goes Mutual aid anyway) is to much work. Much easier to squirt narcan up the nose.

[on the job 68]

Big deal....you give them the narcan and within a hour of entering the ER, the PT is leaving looking for a fix because they get pissed off you revised the high.

It is a revolving door at the ER dept. in Poughkeepsie with this drug addicts doing heroin . Forget the narcan STOP THE DRUGS.

[Bnechis 3,961]

Doing CPR for 20-30 minutes waiting for an ambulance (paged out 3-4 times & goes Mutual aid anyway) is to much work. Much easier to squirt narcan up the nose.

To bad the narcan didn't work on grandma............

But it is so much easier to give every 1st responder narcan than to fix EMS or the drug problem.

[E106MKFD 56]

To add to the list of agencies in the area using Narcan the MTA Police will also be operating with Naloxone Kits.

http://www.mta.info/news-mta-police-mta-pd/2014/05/13/mta-police-force-be-equipped-lifesaving-heroin-antidote

[nycmedic 65]

Just use a bvm until als arrives. I wonder how long it would take for emts cfr or pd to use narcan on a od and put the pt into withdrawals or wake the pt up and he or she becomes violent

[nycmedic 65]

* i wonder how long it would take for the firsr incident

[M' Ave 1,466]

F.D.N.Y. is in the process of training all Engine Co's in the administration of Narcan. Doesn't seem like there's much too it. What's the harm really? There's been a sharp up-tick in the use of Heroine and other opioids, so why not equip first responders with a counter measure.

Remember too, this isn't just for the needle junky in the ally. What happens when your toddler stumbles upon a bottle of Oxy, or whatever, in your medicine cabinet.

It's cheap, it's easy to administer and it's ALMOST completely safe if given when not necessary.

As for fixing EMS systems, I'll leave that for another time and thread.....

[nycmedic 65]

The effects of opiates can be counteracted by using a bvm. You can do alot of harm to the patient and yourself if you give too much narcan. As I said earlier if you give too much narvan you can put them you can put them into withdrawals which will prolong there stay in the hospital. If you give the junky too much narcan and wake him up. Now you just took away his or her high and they usually become violent. Too many people will simply see a person unc with pin point pupils and give the pt narcan even though they have no cyanosis and are breathingat a acceptable rate.

[SteveC7010 58]

While there have been some valid objections raised in this discussion, I must tell you that it's really not going to matter in the grand scheme of things. While this discussion started over Westchester's plan to equip LE with narcan, that is now small potatoes. We just received a copy of the following email that originated with Lee Burns, Director of the Bureau of EMS, NYS Health Department.

It's my observation that the procedural and educational hoops that need to be jumped through to equip EMT's with nasal narcan on board their ambulances look pretty silly when they're just going to hand it out with minimal instruction to 5,000 law enforcement officers.

FWIW, individual ambulance services are still being required to register thier nasal narcan programs with their REMSC's and get signed off by their medical directors.

Seth, back to your original post, it's plain that REMAC and REMSCO involvement in this is being swept aside throughout the state. I suspect it is only the first of a number of medical procedures or treatment that will ultimately fall under a double or even triple standard.

From: Lee S. Burns [mailto:lsb02@health.state.ny.us]
Sent: Thursday, May 15, 2014 11:15 AM
Cc: mdiglio@nycremsco.org; NBenedetto@nycremsco.org; aarems@Frontiernet.net; remohmvi@nycap.rr.com; remodir@nycap.rr.com; execdir@hvremsco.org; director@midstateems.org; mlrems@mlrems.org; Remsco@nassauems.org; jhassett@nassauems.org; Robert.Delagi@suffolkcountyny.gov; director@cnyems.org; info@nycremsco.org; rstueber@flremsc.org; smitha@canton.edu; ccrawford@lakeplains.org; dowlinr@fdny.nyc.gov; director@srems.com; brajsky@emstar.org; ssurprenant@cnyems.org; thowe@nenyems.org; koc1@westchestergov.com; dkahm@sthcs.org; swander@ecmc.edu; semac-l@listserv.health.state.ny.us
Subject: Equipping Law Enforcement Officers to administer Naloxone

Dear Regional EMS Council and REMAC Medical Directors:

The problem of opioid overdose has been increasingly coming to light in the news. This email is written to update you on new developments in NY's response to opioid overdose and to open the door for further discussions with you about the roll out of these new developments in your region.

In addition to our efforts to expand EMS capacity to reverse opioid overdose, you may have alreadty heard about a new initaitive from the Office of the Attorney General. The Community Overdose Progarm (COP) will be preparing officers of law enforcement agencies across NYS to adminiser intra-nasal naloxone in cases of suspected opioid overdose.

The DOH, the NYS Office of Alcoholism and Substance Use Services (OASAS), the Division of Crimnal Justice Servicves (DCJS), Albany Medical Center (Dr. Michael Dailey) and the Harm Reducation Coalition (Dr. Sharon Stancliff) are working together with the Office of the Attorney General to prepare a statewide effort to train approximately 5000 law enforcement officers and equip law enforcement agencies with naloxone.

The DOH recognizes that EMS medical directors, through the various roles they play throughout their region, may have an interest in learning more and perhaps being involved in this large scale effort to train and equip police officers. A statewide training and implementation plan is currently uinder development.

If your REMAC physicians would like to learn more about activities in your region, and possibly be involved in the delviery of training for law enforcement, please contact Richard Cotroneo, Director of HIV Education and Training Programs at the NYSDOH. Richard can be reached at 518-474-3045 or by email rac09@health.state.ny.us

Thank You,

Lee Burns
Richard Cotroneo

Richard Cotroneo, MA, Director
HIV Education and Training Programs
National Hepatitis TA Center
Office of the Medical Director
AIDS Institute
518-474-3045

[M' Ave 1,466]

The effects of opiates can be counteracted by using a bvm. You can do alot of harm to the patient and yourself if you give too much narcan. As I said earlier if you give too much narvan you can put them you can put them into withdrawals which will prolong there stay in the hospital. If you give the junky too much narcan and wake him up. Now you just took away his or her high and they usually become violent. Too many people will simply see a person unc with pin point pupils and give the pt narcan even though they have no cyanosis and are breathingat a acceptable rate.

I've been in the room countless times when some big dudes were given a lot of narcan, enough to wake them up....the violence was overcome by thier need to vomit everywhere.

Point is, in many dozens of occasions, I've never seen someone become uncontrollably violent.

[Ga-Lin 86]

I've been in the room countless times when some big dudes were given a lot of narcan, enough to wake them up....the violence was overcome by thier need to vomit everywhere.

Point is, in many dozens of occasions, I've never seen someone become uncontrollably violent.

The point is the amount of effort that is sometimes needed to establish that control.

[x635 4,066]

Missallocation of precious resources. Should spend the funds on reopening closed companies rather than prolonging life of junkies and subsidizing big drug companies.

That's the same thing as letting someone die in a fire because it was accidental. We're here to save lives, not to judge lives.

[SRS131EMTFF 471]

In my opinion the answer is clear:

Across the board, region by region, state by state, regardless of your certification, affiliation or position; we as emergency responders should at least familiarize ourself with the opiate triad and the administration of IN naloxone.

The modern heroine epidemic is here and we will see it in the streets.

[Bnechis 3,961]

How much effort are we making to PREVENT the use or assist people to get off the drugs? NYS wants to train 5,000 LEO's to postpone the problem. Because giving Narcan will save them...this time...but that just kicks the can down the road.

I saw one study (from Mass.) that showed only 1% of overdoses actually receive narcan, because no call is ever made to 911, because the person is alone and cant or with "friends" who are afraid of "discovery". It also said that only about 10-12% of the narcan in the field is used in a given year, While it did not give a lot of detail, how much of that was to the AMS patient (that did not need it, but we give it incase they needed it)?

Also, with those numbers about 70% of all narcan purchased expires without being used, and that is before we put it out on every PD, FD, & BLS unit.

[16fire5 693]

A factor in this is where this problem is. The heroin epidemic is effecting affluent areas more than the ghetto. Like it or not this gets lawmakers attention and something has to be done! It's no secret that the FDNY trained the Staten Island companies first because they were encountering it at a higher rate per capita.

I'm not disagreeing with what most of the posters are saying just kinda weighing in on how we got to this legislative action. In reality Bnechis is probably right and most of the fatal overdoses are dead prior to the arrival of any first responders.

[SageVigiles 1,194]

Yonkers PD ESU with a Narcan save:

http://www.citizenobserver.com/cov6/app/alert.html?id=38536

Yonkers OEM posted it to their Facebook page.