Medic student needing some help

[Michele]

just curoius what you would put down for an answer on a test. THE QUESTION reads this.What is the appropriate treatment for an overdose of Lorazepam in the prehospital settings? I need feed back please.

thanks, The unhappy medic student

[AZCEP]

First, let's make sure we post in the right place. Folks don't tend to look for great enlightenment in the Funny stuff forum.

Next, is this a multiple choice question? If so, you can eliminate at least two of the possible answers.

Does the question give you any specifics about the patient's condition. Vital signs, associated history, etc, will all give you clues as to what direction you should go.

If this question is being related to your local protocols, then that will change some of the possibilities also. Some medications could be considered, but if your area doesn't have them, then you wouldn't expect to be tested on them.

[Ace844]

just curoius what you would put down for an answer on a test. THE QUESTION reads this.What is the appropriate treatment for an overdose of Lorazepam in the prehospital settings? I need feed back please.

thanks, The unhappy medic student

First welcome to EMTCITY!!! Next, if you utilize the search function button in the upper R hand corner of your screen you will find A BOATLOAD OF INFORMATION ON THE PRECEEDING MENTIONED MEDICINE. To answer your question; I'm sure you'll find Romazicon somewhere in your answer choices..

ACE844

[Ridryder 911]

Of course after all the ABC's has been secured, the generalized treatment is of course is supportive. Some may even recommend Narcan. Romazicon is an appropriate treatment, however; I forewarn anyone that uses it. It is very dangerous reversing benzo's in the field. It is not a pretty sight to see massive seizure activity, and now you cannot control them, because of the mazicon you gave.... basically, your screwed....

R/r 911

[Just Plain Ruff]

Yes that was my first choice, not to chew thru the straps but seriously I would consider romazicon but here are some articles and web sites to supplement the discussion soon to happen here

http://forums.firehouse.com/archive/index.php/t-36280.html

http://www.fpnotebook.com/PSY155.htm

http://www.enh.org/healthandwellness/biote...5.aspx?lid=1093

http://redpoll.pharmacy.ualberta.ca/drugba.../APRD00974.html

i think you will find that for patients who are on benzo's and take an overdose of those benzos that it is contraindicated in that type of overdose.

If they just take a bunch of granny's valiums or what not's then it's not contraindicated.

The thing we have to watch out for is that patients who take benzos for seizures and then they overdose on the benzos in a suicide attempt of gesture then we run a tremendous risk of causing them a seizure and then we have to hit them with an antiseizure medication. Like one of the cardinal rules in medicine states: 1st do no harm!!!!!!!!

If the person is on long term benzo care and they overdose, hold the romazicon and treat the patient supportively - IV, o2, monitor and if needed intubation to protect their airway. I've never run a successful benzo only overdose fatality. Add alcohol and such to it then we are in a different scenario anyway.

I guess the thing to get out of all these articles is give romazicon at your and your patients own risk and if you give it have alternate emergency measures available.

[Ridryder 911]

If one is smart they would do a "trial" dose, like they used to give. This was a small dose to see if any change would occur. The problem of Benzo overdose is, I have yet to see an overdose of any Benzo that the patient was not a chronic user. Very rarely have I or many others seen a first time prescrip of Valium, then overdose...

There are very few services that have Romazicon because of the dangers, we did and pulled it. Never seen an O.D, with a Benzo etiology that was not suspicious abuser in 15 years. ...

R/r 911

[Ace844]

If one is smart they would do a "trial" dose, like they used to give. This was a small dose to see if any change would occur. The problem of Benzo overdose is, I have yet to see an overdose of any Benzo that the patient was not a chronic user. Very rarely have I or many others seen a first time prescrip of Valium, then overdose...

There are very few services that have Romazicon because of the dangers, we did and pulled it. Never seen an O.D, with a Benzo etiology that was not suspicious abuser in 15 years. ...

R/r 911

"Rid,"

As usual i agree with you. Yet, i do believe the Natl Registry still has a number of test questions which relate to this and the meds use, I ask as I am not 100% sure.

ACE

[Michele]

Thanks for getting back to me on this. The anwser they wanted for our county is you wouldnt give Narcan because its not for benzo but he wanted us to put down oxygen. ekg.montior. Well dah thats just assumed that would already be done as our first treatment anyway. I just cant win with these drug quizes.

[Ace844]

Thanks for getting back to me on this. The anwser they wanted for our county is you wouldnt give Narcan because its not for benzo but he wanted us to put down oxygen. ekg.montior. Well dah thats just assumed that would already be done as our first treatment anyway. I just cant win with these drug quizes.

WTF !?!?!?!?

Some how I suspect our efforts here were::

Out Here,

ACE844

[medic001918]

As others have mentioned, the search function is your friend. If you use it, you will find plenty of valuable information regarding benzo overdoses.

Secondly, let's make sure we post in the proper forum. I thought this was going to be a funny thread, not a legitimate request for help. You'll get far more answers in a timely manner when your threads are properly placed.

And onto the question about why they would be looking for IV, O2 and monitor for this patient...while Romazicon could be indicated, I wouldn't want to give it prehospitally due to the many complications associated with it. Sometimes the best thing to do for your patient is supportive care. That would be the most appropriate treatment. So it's not that you can't win with drug quizes, it's that you need to grasp the concepts in their entirety.

Good luck,

Shane

NREMT-P