Noloxone...should EMT-I's be able to administer?

[Dustdevil]

Instead of picking drug X from the box and stating "Why can't I give this, its harmless?" Why not consider giving a little more to the time and effort of becoming a provider who can already give the medication.

For the same reason that every sixteen year old thinks he's the best, most skilled and immortal driver on the road, and that all those traffic laws are for other drivers.

Both beliefs are equally ignorant, erroneous, and immature.

[craig]

NALOXONE PHARMACOLOGY 215TYPE:

Opiate antagonist

ACTION:

Reverses respiratory depression, sedation and hypotension caused by opiate analgesics. The duration of action of the opiate may exceed that of naloxone and renarcotisation is always possible. Ideally a patient should be observed and if necessary repeat doses administered.

USE:

The reversal of opiate analgesic overdosage:

· Heroin · Lomotil (loperamide)

· Pethidine · Pentazocine (Fortral)

· Morphine · Digesic (propoxyphene)

· Codeine · Immobilon (veterinary drug)

· Endone (oxycodone) · Buprenorphine

· Various diarrhoea and cough medicines · Methadone

ADVERSE EFFECTS:

· Opiate reversal can cause vomiting, sweating, tachycardia and hypertension. In patients with cardiac disease more serious effects such as VT, VF and pulmonary oedema may occasionally occur

· Rapid reversal of the opiate overdose may lead to combative behaviour in the patient

PREPARATION:

Naloxone – 2mg per 5ml Min-I-Jet

DOSE:

ADULT

Routes of administration: IV, IM

· SUSPECTED NARCOTIC OVERDOSE:

5ml (2mg) NALOXONE IV BOLUS or IM if a vein is not available

Can be repeated twice if inadequate clinical response

· IMMOBILON OR BUPRENORPHINE OVERDOSE REVERSAL

5 ml NALOXONE IV BOLUS or IM if a vein is not available

Can be repeated to a maximum of 30 mls (12mg)

PAEDIATRIC

Routes of administration: IV, IM

· SUSPECTED NARCOTIC OVERDOSE:

0.25 ml/kg (100 mcg/kg) NALOXONE IV as a bolus or IM if a vein is not available

Each bolus dose must not exceed the adult dose of 5mls

Can be repeated once if inadequate clinical response

Naloxone should not be administered to newly born infants, due to the increased risk of withdrawal syndrome.

Above is our protocol/ pharmacology for Narcan

here the primary care officer (basic to you guys) can give it in certain situations

ALS (both I and P) can give it the same.

stay safe

[Ridryder 911]

As an I/99 I can give Narcan. The question is why can't I give Romazicon?

On a sidenote, most of the older medics I've talked with have said my I/99 is about the same as their paramedic classes (within 10 yrs.). I'm in medic class now and the only real differece l've seen is how A&P is presented. My medic class had a seperate A&P class. Don't get me wrong, obviously there are differences. It frustrates me that the I/99 level is not given the credit it deserves.

No, they should not be administering Narcan as described by the previous post short and simple! Any State that allows it .. is a FOOL!

Now, not to hijack the thread.. but here we go again.........skills versus knowledge...!!!!!! I guess, if you don't have the knowledge, you do not see the importance of it !

I guess, I can do that cardiac by-pass.. I have seen them done a hundred times... it does not appear to look that hard.. DUH! There is a reason skills should be associated with education and license base ! Unfortunately, EMS has not figured that out YET ! That is why EMS is still considered a joke among health professionals.

R/r 911

[Dustdevil]

Word.

EMT-I is given TOO MUCH credit. It is a skills course that TRAINS you to perform a couple of critical interventions to take a load off of a solo Paramedic, or to prep a patient for an ALS intercept in those systems ignorant enough to do that. It does not EDUCATE you sufficiently in physiology, pathophysiology, and pharmacology to make the clinical judgements necessary to intelligently perform pharmacological therapy. And it does not EDUCATE you sufficiently to deal with the potential consequences of that therapy. And if you truly think it does, you are dangerously mistaken and I don't want you anywhere near near me, my patients, or anybody I care about.

[buckeyedoc]

IMHO, the new EMT-I(99) is a law suit waiting to happen. They are given the ability to administer all of these medications and spend very little time, compared to paramedic schools, learning the pharmacology behind the meds. My partner is just completing his intermediate schooling. He has said numerous times that they didn't cover meds very well. More like, if this happens, give this med and not really learning in depth. Narcan is in the new DOT curriculum and as well it should be. Morphine is also in the curriculum and I would like to believe that if you can give a med that can send someone into respiratory arrest that you can give it's antagonist. Then again, maybe I am just thinking to logically.

[Dustdevil]

Then again, maybe I am just thinking to logically.

How dare you!!!

[TechMedic05]

I'm finding, in my neck o'the woods [New Hampshire/ Vermont] that Intermediates are getting more and more, and yet getting the same information. Increasing the imbalance of education. joy. Honestly I'm feeling Intermediates are getting out of control in this area. They now have this feeling of entitlement to drugs and advanced procedures...And yet there is a FD Local who is pressing the state for Intermediates to not re-test practical stations every two years as required by National Registry. Skills that they do not get to practice enough, they feel that 120 hours is MORE than enough across a career. They could be waitresses in a tacky bar based off the number of 'coma cocktails' they've served. At least they're afraid of advanced airways. Combitubes for everyone! Albuterol for SOB is obviously the way to go, regardless of a screaming history of present illness of CHF. They fail to see the need to call ALS for CHF or chest pain, as the hospital is only 15 minutes away. [Aside from the argument that intermediates should have their own Nitro. Oh, Benadryl, too! Benadryl, nothing bad happens, right???Just like narcan, obviously] And of course, every patient gets an IV, and it's always with a liter bag hanging.

Also, other Intermediate; i was once told I had '...No reason to transport a patient because there's no airway issues.'

If Intermediates only see Paramedics as Advanced Airway management, I think we have issues.

](*,) ](*,) ](*,) ](*,)

Sorry, in advance, I didn't mean to hijack.

[Nate]

I wouldn't suggest giving it alone, as there are side effects and you never know what is going to happen. Granted the same thing could be said if you don't give it. Hmm, another reason why we should just require a paramedic on every truck (now there is a good idea).

Seeing as how EMT-I's are taught how to push drugs properly, I see no reason in allowing an EMT-I to push the drug if the paramedic is sitting there with them. If I'm at the head of the patient, the EMT-I is at the side, no reason why they can't be allowed legally to push it. If something was to go wrong I'm there to fix it. Then again that could be said about a lot of drugs as well.

The point is that you don't slam 2mg of Narcan home. You should titrated it to respiration's/effect, to many people think they have to slam 4mg of Narcan and bring them off their "high." Sorry, but I don't like getting my ass kicked, I think I'll keep it so respiration's are good, perfusion is good, and they are semi there. The ER can have the fun of waking the beast up.

I have a question. Do people actually think before they post questions?

[tinman694]

I wouldn't suggest giving it alone, as there are side effects and you never know what is going to happen. Granted the

I have a question. Do people actually think before they post questions?

What do you think?

And Why did you post?

And Why is the sky blue?

Who the hell are you?

[Ridryder 911]

The endorsements of Intermediate level is a management ploy. They can still charge and recieve Medicare ALS charges and not have to provide the same level of care.... Why would you want the extra expense of paying Paramedics ?.. cheap labor ...high revenue... it's all economics folks!

R/r 911