Narcan Auto-Injector Coming

[emt2359]

I heard some states are liking this because the EMT level can easily administer this with minimal training.

Here is the article about the auto-injector.

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm391465.htm

What are you thoughts?

[paramedicmike]

Probably the same as the other thread you started on this topic just a month ago.

[Caduceus]

I read about that a while ago. Apparently there was also some thought given to the concept of making Narcan autoinjectors available to people who have family addicted to drugs, so they can be used similarly to an epi-pen. Personally I wonder how many lives could be saved with it, or if it would make families and addicts more lenient. Like they wouldn't try as hard to get off the drug/go to rehab??? What are your guys thoughts on that?

Edited April 18, 2014 by Caduceus

[island emt]

my thought on drug abusers is : give them all they can smoke , snort ,shoot up or stick up their arse and they will all be dead within a few months.

No more drug addicts.

Same theory goes for fat people. Give them a spot at the counter of Mc ratmeats or at the local chinlee all you can eat buffet, and let them eat themselves senseless.

We have a fellow that has been basically imprisoned in an ICU double room at the hospital because he had gotten up to well over 1100 pound of stinking festering blubber laying on a pile of 4 mattresses on the floor in weeks worth of his own waste.

Now he hadn't been out of that room for months until the fire dept with assistance of a towing company removed him.

They have managed to slice almost 400 lbs off him on a STRICTLY controlled diet over 6 months and not allowing anyone in the door with food. This is a slob who was consuming 25,000 calories a day as a warm up snack to getting down to serious eating.

Do I have any sympathy for people like that???

NOPE

used it all up many years ago.

going back to the autoinjector issue :

the new users of the medical device will receive a 20 minute class on how to use them.

They will not have a background knowledge of the pharmokinetics , or the possible problems involved with aspiration or sudden reversal of the OD pt.

They won't have the knowledge or ability to respond to manage those dangerous side effects they can cause with narcan administration.

Edited April 18, 2014 by island emt

[Just Plain Ruff]

my thought on drug abusers is : give them all they can smoke , snort ,shoot up or stick up their arse and they will all be dead within a few months.

No more drug addicts.

Same theory goes for fat people. Give them a spot at the counter of Mc ratmeats or at the local chinlee all you can eat buffet, and let them eat themselves senseless.

We have a fellow that has been basically imprisoned in an ICU double room at the hospital because he had gotten up to well over 1100 pound of stinking festering blubber laying on a pile of 4 mattresses on the floor in weeks worth of his own waste.

Now he hadn't been out of that room for months until the fire dept with assistance of a towing company removed him.

They have managed to slice almost 400 lbs off him on a STRICTLY controlled diet over 6 months and not allowing anyone in the door with food. This is a slob who was consuming 25,000 calories a day as a warm up snack to getting down to serious eating.

Do I have any sympathy for people like that???

NOPE

used it all up many years ago.

going back to the autoinjector issue :

the new users of the medical device will receive a 20 minute class on how to use them.

They will not have a background knowledge of the pharmokinetics , or the possible problems involved with aspiration or sudden reversal of the OD pt.

They won't have the knowledge or ability to respond to manage those dangerous side effects they can cause with narcan administration.

Have you had your morning coffee yet? That post was downright depressing.

[rock_shoes]

my thought on drug abusers is : give them all they can smoke , snort ,shoot up or stick up their arse and they will all be dead within a few months.

No more drug addicts.

Same theory goes for fat people. Give them a spot at the counter of Mc ratmeats or at the local chinlee all you can eat buffet, and let them eat themselves senseless.

We have a fellow that has been basically imprisoned in an ICU double room at the hospital because he had gotten up to well over 1100 pound of stinking festering blubber laying on a pile of 4 mattresses on the floor in weeks worth of his own waste.

Now he hadn't been out of that room for months until the fire dept with assistance of a towing company removed him.

They have managed to slice almost 400 lbs off him on a STRICTLY controlled diet over 6 months and not allowing anyone in the door with food. This is a slob who was consuming 25,000 calories a day as a warm up snack to getting down to serious eating.

Do I have any sympathy for people like that???

NOPE

used it all up many years ago.

going back to the autoinjector issue :

the new users of the medical device will receive a 20 minute class on how to use them.

They will not have a background knowledge of the pharmokinetics , or the possible problems involved with aspiration or sudden reversal of the OD pt.

They won't have the knowledge or ability to respond to manage those dangerous side effects they can cause with narcan administration.

Good grief island. I was almost flame kissed just reading that post. The key here is empathy not sympathy.

Where I do agree with you is regarding the legalities of addiction. Stop turning people into criminals because they happen to abuse a substance on the list of things that are illegal to use. Stop waisting money on forcing people into court mandated treatment (only offer it and allow people to enter when they are ready to actually make a change). If we do just those two things millions of dollars will be saved.

In the short term we need to provide critical interventions to give these people the opportunity to seek out recovery. It is not any of our place to refuse life saving treatment simply because a patient's own actions lead to the circumstance in which we find them.

Regarding the naloxone auto-injectors, it's my understanding they are pre-loaded with a relatively conservative dose. Conservative dosing (0.8 to 1 mg IM) should eliminate the majority of issues with respect to someone coming off the nod too quickly. Yes ideally these patients are ventilated and pre-oxygenated, but a little confused/hypoxic is better than dead.

[island emt]

I probably came off as being against the narcan being made available.

Not so.

There just needs to be a serious effort involved in the training & use of them, and knowing what to do when the known effects happen. Things like you zap them and figure it's all better now, don't need to call EMS, or what to expect if the pt suddenly starts to vomit violently.

I grew up in EMS during the heroin wars of the 70's & 80's where junkies were a third of our call volume in an inner city environment.

Closest I ever came to getting shot was getting caught in the middle of a disagreement between rival drug gangs in a tenement in the hood of Holyoke Mass while we were going to treat a stabbing victim.

Am I a wee bit unsympathetic for their plight?

YES

[chbare]

Look back at the other thread. I asked the same questions that I will ask again. Putting personal feelings and potential bias aside, what does the evidence show? Do these programmes exacerbate the problem, enable abusers, increase the risk to providers, patients and bystanders? Again, I ask where the evidence points. How are these programmes working out in states that use them?

[ERDoc]

I don't think we have been doing it long enough to know about long term consequences.

[chbare]

There is still a fair amount of data we can look at and use to determine if we should continue or expand programmes. Clearly, long term evidence will be derived from said programmes. I am not convinced that we should stop or limit things. Perhaps long term data will show something different and I will have to change my mind.