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To those who say "just bag," I would say it depends on where you work. Where I do BLS shifts we are about 45minutes from the hospital, which is a long way to bag. Also I feel like you have a much higher chance of the patient vomiting from prolonged bagging, forcing air into the stomach, than if you use a little Narcan.
To the idea of making everyone an EMT-I, it sounds great. But I have 2 issues.
1. I know a lot of EMT-Bs who I wouldn't trust with an IV and I don't think have the smarts to give drugs.
2. Is it fair if most people are paying for EMT classes out of their own pocket to make them pay for an EMT-I class, which will be longer and more expensive? You could argue that they would make more but I don't think our healthcare system is going to give all EMTs a raise right now.
Firstly if you are 45 minutes from a hospital that's even more reason to be up skilled to provide all you patients with optimal care.
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This would be somewhat similar to the opinion that giving BLS a King or Combitube is useful, not to replace intubation, but to replace unassisted bag-mask ventilation.
The world is finally coming around to the facts that 1. One-person BVM is often quite difficult,.
and 2. We're not going to do mouth-to-mouth or mouth-to-mask so stop mentioning it. The consequences of this are numerous.
I am appreciative of the view, espoused by Rogue and others, that all the narcotic OD needs is bagging for his respiratory depression. However, realistically, in this world, ventilating with the BVM alone is not always easy, and if it comes down to the choice between sticking to the "principle of least medicine" and letting someone become hypoxic because you can't seem to reliably get the air in, it would be nice to have an effective out.
I cannot buy into this argument at all.
Nobody ever died from not having a plastic tube in them. They die from not having a viable airway.
Somehow back in the days of wooden ships and iron men, when our options were manual maneuver, EOA, or intubation, we somehow managed to ventilate all but the most greviously injured trauma patients where the airway and surrounding structures were destroyed or burned.
These devices are not without their problems, and nobody benefits from from trying to make up for poor technique or lack of skill with a gadget.
What???
I have never had a problem and I have been around a while in some very high volume environments.
This I agree with.
What???
I have never had a problem and I have been around a while in some very high volume environments.
I dont quite understand to two person BVM, so AHA is saying you would need 3 rescuers for a CPR, minimum. Unreasonable, BVM use is a skill like splinting, and requires practice, but it is not an impossible skill. As a Basic provider, its one of a handful of skills in our bag. I dont think proper BVM use is difficult
As far as IN Narcan, with proper education, pharmacology, i dont see why not, but i also dont see why
Why?
What were you trying to accomplish? These are asphyxial arrests caused by a prolonged period of blunted respiratory drive. How is narcan going to fix this?
That's good, but it's not the case for many providers. I assume there is a reason that 2 person BVM use is now being promoted by the AHA
The person doing compressions can squeeze the bag twice and then return to compressions while the other provider concentrates on maintaining a good seal.
If you don't think proper BVM use is difficult, I have my doubts you've bagged all that many patients.
Dr. Weingart stated the BVM was a bigger murder weapon than the laryngoscope on one of his podcast. I can't say I disagree.
It's not interrupting compressions. Compressions aren't being done while breaths are being delivered if an advanced airway is not in place. So long as the bag is angled the proper way while compressions are occurring and the seal is maintained at all times, it will take well less than 5 seconds to deliver the 2 breaths from the BVM following 30 compressions.No, shouldnt interrupt compressions, especially not for ventilation, which we still havent shown has any real benefit
Why would you give narcan in arrest? What are you trying to accomplish?
My knowledge on this is quite limited, but I assumed that in the event of an arrest caused by prolonged respiratory depression/hypoxia that it may improve the chances of survival. I dont have the knowledge & training on that drug so please correct me if I am wrong.