Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Comments on What About Nebulized Naloxone (Narcan)

There have been some interesting comments on What About Nebulized Naloxone (Narcan) – Part I.

Let me start with the sarcastic comment that suggest that everyone is opposed to treating patients with heroin ODs (OverDoses).


Image credit.

Mike writes –

Why do we even touch the OD patient to begin with? They didn’t call for an ambulance. If they’re breathing, let them stay. They paid for their fix, let them enjoy it.

If a person is not requesting medical help, is breathing adequately, and protecting his airway, how do we justify treating the patient against his will?

They obviously cannot be helped by any sort of treament program and would never benefit from medical care.

Where does this conclusion come from?

This is something that is completely made up by Mike.

Nobody has suggested anything of the sort.

Why should feel some sort of responsibility to help these patients? Because they might have families and children? Screw that. They obviously want to die, or at least get high, so what business is it of ours? It’s just like those damn suicidal patients.

More made up nonsense that appears to be designed to allow Mike to feel superior to others.

None of it is true of any of the comments Mike is responding to.

It’s not like a heroin user has ever been rehabilitated and done something useful with their life.

More examples of an apparently fevered imagination.

Pulling us away from reading studies and saving real people by figuring out the exact process to get those cardiac saves. Those are the ones we need to focus on. Sure they’re one out of a million, but at least the 76 year old woman we save will get another few years in the nursing home.

Avoiding research is ethical?

In what way does inflicting baseless treatment on patients even come close to being ethical?

But when Mike wants to make up his criticism, we should not be surprised that he also might want to make up his treatments.

I can’t wait to be as jaded as you guys.

We are not jaded when we are interested in providing informed consent to patients and not treating patients against their will.

angelo responded to Mike with some clear comments, but Mike replied by just demonstrating his biases.

“I’m just curious what medical condition you think a breathing person who is altered from doing heroin has”

How do you plan on assessing them appropriately when they are unresponsive?

How many of these patients are unresponsive?

The mean GCS (Glasgow Coma Score) was just under 12.

 

An average GCS of 12 is unresponsive?

 

Is Mike’s GCS above 12?

Is drug dependency no longer a medical condition?

Drug dependency is not something for which I have a protocol.

Drug dependency is not an emergency medical condition.

Is a heroin overdose an automatic exclusion from any comorbidity?

Why are you assuming comorbidities that require emergency treatment?

Why are you assuming comorbidities that would be ignored?

Why are you assuming that these patients would not be assessed?

Naloxone does not treat comorbidities.

 

Naloxone is not an assessment.

 

Or, are they just not treated because it is felt that they are not worth the time?

I understand that these can be difficult patients, but sometimes you just need to suck it up and be a damn professional.

What patients are not being treated?

What patients are not being treated appropriately?

Giving a treatment that is not in the best interest of the patient is unprofessional.

Nobody has suggested any unprofessional treatment, but Mike continues to make up unprofessionalism to pretend to justify baseless ranting.

What Mike has failed to understand is that the people commenting here (SubUrbMed, angelo, and Prehospital RN) have been advocating for better treatment of patients presenting with signs of a heroin OD. Mike is the one who is opposing professional behavior.

We need to study ways to provide the best care to our patients.

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Comments

  1. It was difficult for me to figure out if Mike was being serious in that post or not. Some of those statements seemed a little over the top.

    On the subject of the posting, I believe IN narcan could be a useful tool for FRs and police with the proper training as well as the proper protocols. It appears that protocols that allow FRs and police to use IN narcan put so many restrictions on its use that they have the choice to give it against protocol in legitimate situations or just never give it at all.