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Overdose first aid treatment

Discussion in 'First Aid Station' started by TOPOS, Jun 20, 2016.

  1. TOPOS

    TOPOS Loaded Pockets

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    Does anyone have experience dealing with people who have overdosed, specifically on heroine. A few days ago there was a 3rd overdose within a mile of my house. I've decided that this is something that i should know how to treat, or at least begin to treat.
     
  2. buck268

    buck268 Loaded Pockets

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    Take a CPR course and especially pay attention to rescue breathing. Have some form of barrier device such as a pocket mask or bvm handy.

    Most of all, call 911. Many, no most OD patients are none to happy when they are "saved" from their high by naloxone.

    Sent from my HTC6515LVW using Tapatalk
     
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  3. Swe_Nurse

    Swe_Nurse Loaded Pockets

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    Yes, CPR is a good start. Don't bother with those flimsy plastic film "masks", either get a proper mask or do compression only CPR.

    Other than that learn the recovery position, it will come in handy (taught in CPR-classes).
     
  4. EMT_Carry

    EMT_Carry Empty Pockets

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    Echoing what has been said already, a good solid pocket mask to support their breathing and be prepared to do CPR. We get alot of Heroin ODs on my patch when I do 999 Civilian shifts, remember to keep yourself safe above all else.
     
  5. VinnyP
    • In Omnia Paratus

    VinnyP Loaded Pockets

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    Yep stick to the ABCs, with emphasis on the B. It's all a first aider can do. With Morphine we carry Naloxone which will work with Heroin. But outside what you can do for the poor fellow you describe.
     
  6. derfyled

    derfyled Loaded Pockets

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    Be sure to check first if they don't have a syringe in their hands to avoid being stung by accident.
     
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  7. bcWRX-02

    bcWRX-02 Loaded Pockets

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    Fentanyl-laced drugs have become a huge problem in my area, as such Naloxone (Narcan) is now available over the counter and being given out for free at community outreach centres. The direct-to-patient kits come with a pre-loaded syringe with instructions for how to administer, depending on good samaritan laws in your area this may be a product you could get and administer.

    I do however agree with the above posters in that airway management is key, assisting breathing is often necessary as that is one of the hallmarks of narcotic OD, and rescuer safety is paramount. We often administer a smaller dose of naloxone than is indicated by protocol as many addicts are quite violent when coming out of an OD.
     
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  8. TOPOS

    TOPOS Loaded Pockets

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    bcWRX-02 out of curiosity, where in Canada are you from? I live I New Hampshire, where narcan recently has been made available with a prescription. But, I can't get a prescription due to being a minor. i probably will get one when im 18 though.
     
  9. Iafrate

    Iafrate Empty Pockets

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    As a retired paramedic, I know a little about OD management. For any opiate, i.e. herion, morphine, hydrocodone etc, the definitive treatment is Narcan ( nalaxone). Bear in mind Narcan has a fairly short half life so tertiary care is needed. Drugs such as Tylenol requires hospitalization. Too much Tylenol will fry the liver. Benzodiazepines i.e. Valium( diazepam) Ativan (lorazepam) taken by themselves are somewhat benign but can and do function as a respiratory depressant. Romazicon is a specific antagonist for benzodiazepines but only found in ERs and some ALS units. Aspirin is also extremely dangerous in large doses. Salicylate poisoning is a horrible way to go. Aspirin also blows acid-base balance out of whack but is readily mansgeable in the hospital. For the layman, supportive care is really all you can do, maintain the airway, place pt. on their side in case they puke so they wont aspirate. Then call 911 as definitive care is in order. Any drug can, in the OD context lead to a potentially life threatening situation. How much time has passed since oral injestion is important as inducing emesis may be indicated. If that is done, try and recover any pills and take to the ER. Level of consciousness is critical in that decision tree. If in doubt call 911. And yes, opiate addicts will get pissed after they receive Narcan and lose their high. Ive been hit more than once under those circumstances.
     
  10. Timlugia

    Timlugia Loaded Pockets

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    If it's prescription, then you general can't use it on someone else.
    This is also way above your training level in most jurisdictions, except a few places, you usually need to be EMR or higher to administrate Narcan.
     
  11. bcWRX-02

    bcWRX-02 Loaded Pockets

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    I'm in British Columbia, and we've had a massive influx of illegal Fentanyl out of China mostly in the last year which has made it's way into street level drugs. I think we will start to see Narcan become more readily available as this is a growing issue across Canada and likely the US as well. It's very safe to administer, and most Fire departments (we have separate fire and EMS here) are being trained to carry and use Narcan, as are the general public in areas where OD's are more common.
     
  12. Iafrate

    Iafrate Empty Pockets

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    The cool thing about Narcan, is it is impossible to overdose someone with it. I have seen Narcan drips in the hospital running for hours. Ultimately this means you can literally do no harm with it. While IV is the preferred and most effective administration route an IM injection works just fine, just takes a tad longer for the desired effect.
     
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  13. TFin04

    TFin04 Loaded Pockets

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    Don't put your mouth on a stranger, mask or not.
     
  14. VinnyP
    • In Omnia Paratus

    VinnyP Loaded Pockets

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    That will seriously dent some people's social life.

    With a good mask I have and will continue to if necessary. Let's hope others are not as selfish as you if you or your family are the ones who need help.
     
  15. TFin04

    TFin04 Loaded Pockets

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    Selfish? I reverse overdoses for a living. I have the tools to avoid putting my mouth on people.

    But if I'm off duty? No way. I am not risking MY safety and therefore the livelihood of MY family for someone else's terrible life choice. I don't judge drug addicts, there is a number of reasons why people use. But there is no denying it is a dangerous choice. Their lack of self control is not worth risking what I have worked hard for and earned for me and my family.

    If you would put a drug addict stranger's well being above your own safety (and potentially your family by connection) for some sort of self fulfilling hero complex, YOU are the selfish one.

    Buy a pocket BVM if you're so set on getting dirty.
     
  16. VinnyP
    • In Omnia Paratus

    VinnyP Loaded Pockets

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    I've got plenty of pocket BVMs. But it's not really the kind of thing I keep in my pocket. Whilst this thread was about overdoses you said you advocated helping NO ONE if you have a barrier mask or not. I do carry a barrier mask and there is far less chance of catching something potentially fatal or serious airborne using one of those for mouth 2 mouth than being in a emergency room or Dr's surgery.

    Sent from my SM-G935F using Tapatalk
     
  17. TFin04

    TFin04 Loaded Pockets

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    I didn't say help no one, I said don't put your mouth on a random OD. Assumptions and all that...
     
  18. thekapow

    thekapow EDC Junkie!!!!!

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    thats not really what you said.
    Mask or not, sounds alot like 'help no one' to me.

    Thats two very different things, I agree with mouth to mouth, I woudnt do it, but that means that i carry a pocket mask 24/7 and wouldnt hesitate to use it and administer CPR to who ever needs it.
    My opinion, you picked the wrong job.
     
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  19. polak187

    polak187 Loaded Pockets

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    Ok here you go. I work Staten Island which has the most amount of pharmacies per sq mile than any other place in the US which leads to a lot of ODs on opiate based pills/patches (both legal and illegal). On top of that we got our heroin/methadone ODs that fill the gaps. Both FDNY (me) and NYPD carry Narcan (antidote) kits and I believe family members of those affected by the ddiction can get their kits to keep at home. Few times we got on scene and pvt owned kit has been administered. Now the goal of Narcan admim is to give it before resp compromise (bradypnea/slow resp) changes into resp failure than into resp arrest than into cardiac arrest. We are talking something that can last hours to as little as 5 minutes. People after Narcan admin will either be obtunded and lethargic, violent or go into seizures from withdrawal causing further complications and may need to be sedated. Narcan should be administered in controlled doses in order to correct the respiratory rate to be satisfactory for proper perfussion.OD treatment prior to Narcan administration includes rescue breathing ico resp failure or cpr in case of cardiac arrest. Narcan can be administered thru the nose (ontranasal) which is a preferred route as it is the safest, easiest and reduces possible exposure to blood born pathogens. Intramuscular and intravenous are other option but you have a sharp (needle) present which always causes a risk of injury to you (aka stick yourself) and patient you deal with statistically has a higher chance of having HEP or AIDS. Narcan is also a short acting drug. In a nut shell Narcan pushes opiates out of the "receptors" and replaces the drug so it can not get back in. Opiates still circulate in the blood stream as they are not eliminated therefore after a while when Narcan "leaves",opiates go back to the same receptors again and you are back almost to square one. That's a problem when you save somebody on the street with narcan as a bystander. They get up, tell you to fly a kite, walk away before PD and FIRE gets there and than somebody finds them dead in their home. ME establishes time of death, PD looks into their log, they have your name and you are in trouble.

    Now personally I don't know where you are coming from because it is a bit weird to own a Narcan kit without having close fam that has opiate problem. To use your prescribed kit on a stranger we are talking huge liability here. That medication is prescribed to you or your family, if used patient can cause harm to self, you and bystanders, you can get infected/exposed, you may bring back somebody who has some kind of mental/physical deficit due to the time their brain was without oxygen. All these things lead to law suits. Proper admin requires training and medication expires on regular basis. I would stay away from it. Learn proper CPR. Whatever you want to put your mouth with or without pocket mask on somebody can be your little secret. Hands only CPR is fine until help arrives. Opiate overdoses are especially devastating because they do not differeniate between race, class or beliefs. I stood there explaining to wives, husbands, parents, kids, poor, rich and coworkers that it was too late. That there was nothing we could have done. In some cases their cries are still with me because it was a senseless death that destroyed a family. Again learn CPR that helps stay away from narcan unless your reason is closer to heart than just wanting to have it.
     
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  20. TFin04

    TFin04 Loaded Pockets

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    You have it all figured out from a couple of forum posts? Perhaps you should be on Wall St with foresight like that. You're making assumptions and taking my post completely out of context. I hope you don't force a patient's presentation into your first suspicion the way you are to me, that is dangerous medicine.

    There is clear data supporting hands only CPR, and all of the major entities that teach these things (AHA...) agree as well. Do what you want, but modern data supports the best thing for both the single rescuer and the victim is getting on the chest hard and early.