With the volunteer system in SoMD as a backup, we rarely run out of ambulances. In places like DC where ambulances are a constrained resource, we already have cardiac patients dying while paramedic units are tied up with addicts and their choices.
Narcan
- Thread starter SquirrelBait
- Start date
With the volunteer system in SoMD as a backup, we rarely run out of ambulances. In places like DC where ambulances are a constrained resource, we already have cardiac patients dying while paramedic units are tied up with addicts and their choices.
-Serious question, how do you tell the difference? If they are breathing and their heart is still beating do you still give them Narcan??
Narcan is used to reduce the effect of the opiate on the patients respiratory system. If they are breathing adequately, and have no signs of inadequate perfusion < blue lips for example > then Narcan may not be given.
-WHO decided where are EMT's go? We have a limited number of rescue squads, and even more limited Emergency Care units. IF they get a call for an overdose, and a family man down in his front yard possibly having a heart attack who decides who gets the last ambulance available?? Will they divert an rescue squad on the way to an OD when a call like mentioned above comes in?? How about a family in a car accident?? Husband, wife and kids in need of emergency care??
EMS are dispatched by the Emergency Operation Center in Leonardtown. We < I'm a Paramedic > go where we are dispatched. If we are enroute to an OD call, and the call you mentioned goes out, we have the authority to re direct our unit to the call. Its all based on the situation. Is there a BLS < Basic Life Support > ambulance enroute to the scene ? They carry Narcan , are trained to recognize an opiate OD , and can administer it if the situation dictates < patient presentation > Is there another Paramedic onboard the ambulance as well as the BLS members? If so, they will have a complete ALS ( Advanced Life Support, Paramedics > kit on the ambulance. Again, the situation will dictate the EMS response < within reason >
Chris0nllyn
Well-Known Member
I argue prescriptions of opioids is what is driving the heroin problem now.
Clem72
Well-Known Member
Doesn't change the fact that wasting tax payer dollars to bring drug abusers back to life only to drain hard working people even more. If you don't see that then I would venture to say that you are a common sense hack.
They should then be able to refuse to pick up smokers having an emphasima/asthma attack. And of course don't pick up the fatties having diabetes or cardiovascular issues.
Maybe slip a bit further down this slope and don't pick up people who broke bones at sporting events. You chose to engage in physical contact, my tax dollars shouldn't provide you a free ride to the hospital.
PeoplesElbow
Well-Known Member
Difference none of that is illegal.
What's driving it is (a) the lack of mental health services, i.e. medical doctors and (b) cheap heroin. It's become the drug of choice for those with untreated mental health issues.
Not as cheap as alcohol, but cheaper than pills.
I think people should have an IQ/Ignorance card in their pocket, those with a certain score don't get emergency services. A lot of you would be left to die.
Overdoses are the everyday user, typically the overdose patient is one who has stopped using and falls off the wagon. Again, you might be happy to know, a group at highest risk is people just released from jail (that's where we send our drug addicts), because booze is a socially accepted way to destroy your life, we let alcoholics off the hook. Both diseases are treated in similar manner. Root cause of both are the same. Typically people with untreated depression and/or anxiety.
Chris0nllyn
Well-Known Member
All very good points, and all true. I just disagree on the root cause.
I had to do a research paper last semester on heroin. That included what drove the increase in use. Many many things point to an over-prescription of opioid painkillers.
It is certainly what gets many addicts started on the opioid track. The actual OD is usual heroin or a heroin/fentanyl or heroin/carfentanyl mixture.
It is uncommon to see ODs from prescribed opioids in a non-addict who takes them for cancer or an acute injury.
luvmygdaughters
Well-Known Member
I agree, I've known people who were prescribed opiate pain killers and did not turn into a heroin addict. I think a lot of it has to do with personalities.
Restitution
New Member
Been in that situation several times myself (various surgeries). Always had a partial bottle of the prescriptions left over too.
Chris0nllyn
Well-Known Member
In many cases, that's true. Heroin is much cheaper than pills, but users don't really know what's in it.
Michael Jackson and Prince are two notable deaths stemming from prescribed opioids, so it certainly happens. According to the CDC, synthetic opioids (not methadone) accounted for 9,580 OD deaths in 2014-2015. During that same time period, heroin accounted for 12,989 deaths. They aren't far off, but heroin certainly gets the most coverage.
Michael Jackson received propofol which is not an opioid. It is an anesthesia drug used to produce unconsciousness. And while it was technically prescribed, the very action of prescribing it was later determined to be a crime by a doc acting way outside of what is considered regular medical practice.
Similar story with Prince. While his death was ruled an accident and caused by fentanyl, the feds put quite some effort into finding out how he received the drug as it was outside of the regular prescription system.
http://www.abc.net.au/news/2017-04-...end-doctor-helped-star-obtain-opioids/8450116
Both Prince and Jackson had dealers that supplied them with drugs. Their dealers just happened to have medical degrees.
Outpatients receive Fentanyl mostly through patches. If used as instructed, there is a very low risk of overdose as the release is very slow.
That's mostly the result of fentanyl and cafentanyl being mixed in with heroin. There is some really spooky stuff out there that is tens of thousand times more potent than heroin.
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Chris0nllyn
Well-Known Member
Did you see the story out of California (San Diego, I think?) where some folks were busted with 90 POUNDS of powered fentanyl. Considering the amount that can be lethal to humans, it was estimated to be enough to kill 14 million people.
It's nuts.
And that's 'just' fentanyl. The same potency would fit into a single pound of carfentanyl or U47700.
At one point poisoning a cities water supply with LSD was thought to be a possibility, cartridge of carfentanyl placed in a city water main downstream from the treatment plant could wipe out a good part of the population (except in Baltimore where 1/3 of the population would be so tolerant to opioids that they would survive ;-) ).
In which case, if a biker doesn't have on a helmet and appropriate protective gear, they should refuse to send an ambulance. Helmets are required by law.
Same would go for an vehicle accident where it was determined the one or more of the occupants were not wearing seatbelts, or there are indications the driver was using a cell phone, or speeding. I mean the possibilities are almost endless so why bother sending help at all, you can just assume something preventable was done. After all, highway safety experts don't call them accidents, they call them collisions. An accident is something beyond the control of humans, like a lightening strike. Everything is man made and called a collision.
Restitution
New Member
If the biker, vehicle accident victim(s), occupants, speeder, etc. were all found to be heroin addicts and need the NArcan at the scene to be revived then I would say YES... please include them
a personality can be changed, it's a learned. Depression, anxiety, bi-polar, are verifiable mental health diseases. Doctors have no idea if a patient is going to become addicted anymore than a bartender knows the customer will become an alcoholic.
If the biker, vehicle accident victim(s), occupants, speeder, etc. were all found to be heroin addicts and need the NArcan at the scene to be revived then I would say YES... please include them
you miss the point tool, all the calls would be for people doing something illegal. So the suggestion is, since most collisions are caused by humans doing something in violation of the law, why not just not respond to those crashes? After all, they are law breakers. Or are you specifically only targeting addicts? How about alcoholics? Mexicans (they could be hear illegally)? Who else should we put on the "do not resuscitate list" so your sensibilities are not offended?
luvmygdaughters
Well-Known Member
If the bartender sees the patron getting $hitfaced, its up to the bartender to stop serving the patron. If not, when the patron leaves and kills somebody due to drunk driving, the bar owner and bartender can all be fined for serving said patron. Maybe doctors should pay a little more attention to what they are prescribing and to whom. Instead of prescribing say, 30 pills, they dole out 5. If the patient needs more, they have to come into the office, submit some blood work and maybe try something else for pain modification.