Should basic EMTs be giving naloxone (Narcan) when paramedics do not really understand the drug?
If a patient wakes up after naloxone, does that mean the patient had a drug overdose?
No – but most paramedics do not understand that.
As of January 1, 2014, there will be even more people giving Narcan with little understanding of what they are doing.
La Crosse firefighters soon could start carrying a life-saving drug for heroin users. The department is applying to be one of the state’s first groups of emergency medical technicians to administer Narcan, the antidote to an opiate overdose.
Does naloxone save lives or just make it less work for first responders?
If the basic EMTs are not good at basic ventilation, will they be any better at drug administration?
Are drugs the cure for ventilation problems?
The department has witnessed a 53 percent jump in the number of potential drug overdoses since 2009, Chief Gregg Cleveland said.
In 2012, firefighters responded to 98 potential overdoses and 86 so far this year.
A 53% increase?
98 last year.
86 so far this year (as of October).
10 months in, so an average of 8.6 per month = 103.2 for the whole year.
Going from 98 to 103 is not a 53% increase.
It isn’t even a 5.3% increase, but only 5.1%
Only 5% – not 53%.
Correction (13:00 12/28/2013) – the math is not based on the numbers in the article and I did not read the article correctly. The bad math is mine, not Chief Gregg Cleveland’s. Thank you to Christopher Jennison, Jordan L, and Parastocles for pointing out my error.
I apologize to Chief Gregg Cleveland for misrepresenting his statement as bad math, when it was my mistake.
What kind of time would be saved by having the fire department give naloxone?
What kind of bad outcomes would be prevented?
What kind of better outcomes would be expected?
What is the added cost of implementing this program?
What other programs would be deprived of this money?
Those are just some of the questions that should be asked.
The main question is –
If your fire department is doing such a bad job of managing BLS skills (BVM, positioning, painful stimulus, . . . ), why should we allow you to harm patients with ALS skills?
If your department is not harming patients, then where is the need?
Naloxone does not appear to be the answer to either problem.
Will naloxone cure the math problems of these drug pushing managers?
Six of the 25 complete responders to naloxone (24%) ultimately were proven to have had false-positive responses, as they were not ultimately given a diagnosis of opiate overdose. In four of these patients, the acute episode of AMS was related to a seizure, whereas in two, it was due to head trauma; in none of these cases did the ultimate diagnosis include opiates or any other class of drug overdose (which might have responded directly to naloxone). Thus, what was apparently misinterpreted as a response to naloxone in these cases appears in retrospect to have been due to the natural lightening that occurs with time during the postictal period or after head trauma.