# Narcan Use Survey



## Andrew Nelson (Jul 2, 2016)

Please respond to my survey about Narcan use as a diagnostic tool. Thank you! 

https://www.surveymonkey.com/r/CMKVYVC


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## STXmedic (Jul 2, 2016)

Out of curiosity, what's the goal of that survey?

Also, you don't have zero as an option for number of times.


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## WolfmanHarris (Jul 2, 2016)

So I completed your survey. However, if you're attempting to do research or a school assignment via this survey you need to do a LOT more work. Any data you collect from this is going to be garbage; you have zero context. Do I work rural or urban? Are narcotics OD's common in my area? Transport time? Etc.

The wording of your questions is slanted to pursue a desired outcome. Better to have a series of questions that establish attitudes towards narcan, experience and ease with using, fears and barriers to usage, etc.

That's without considering whether using a drug as a "diagnostic tool" is a good idea to begin with or ethical. You've taken these as givens.

If you're trying to make a case within your service, do it scientifically, don't hand over survey monkey from an anonymous website to your medical direction or management. Wallow in the research and make a case from the science.

For instance our current medical directive for narcan is surprisingly restrictive, especially given that narcan is available OTC for free in Ontario. Our directive provincially requires complications with ventilations and a patch to Base Hospital MD for permission (we very rarely patch in our system). My argument has been that PPV is not a benign intervention and has known, realistic complications that can only be partially mitigated by the Paramedic. Given reversible causes, intubation is a poor solution when a titration of IV narcan to restore adequate respiratory drive can remove these risks without exposing the crew to the hypothetical risk of violence. That's my opinion and I think it's reasonable, but until I'm ready to start backing that with research, usage stats from my area or comparable areas and actually back it up, it's just that, my opinion.


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## Andrew Nelson (Jul 3, 2016)

I appreciate the response and I'm aware it's not best data collecting. It's for my third semester of paramedic school so needless to say I just need some numbers to throw on a paper with some words. Also the free account on survey monkey only allowed for four questions. 

Regardless I can still somewhat gauge if medics are using it as a diagnostic tool in some cases when they are stumped. I am curious what would be unethical about giving 0.5 mg just to rule out a possible cause? Is it not given in codes with unknown etiology? 

I originally came up with the topic because I witnessed ER doctors on more than one occasion ask EMS if they tried narcan to rule out narcotic overdose. If they had not they put in an order for it right away. As you know the docs go through a tad bit more schooling. So this sparked my idea that maybe it should be used more in the field to possibly help the doctors speed up treatment plans.


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## Carlos Danger (Jul 3, 2016)

Andrew Nelson said:


> I appreciate the response and I'm aware it's not best data collecting. It's for my third semester of paramedic school so needless to say *I just need some numbers to throw on a paper with some words*. Also the free account on survey monkey only allowed for four questions.



It's pretty evident by the way that you worded your questions that you didn't take this project seriously, and your comment here just confirms that. Why should anyone else bother to help you with something that you don't care about yourself?



Andrew Nelson said:


> I can still somewhat gauge if medics are using it as a diagnostic tool in some cases when they are stumped.



No, no you can't. Not at all.

Let's say that 50% of respondents to your survey have never use naloxone as a diagnostic tool, because to many of us, the "coma cocktail" is a thing of the past. And let's say that many of those respondents chose "1-10", because 1 is the closest choice to the number of times that they've used it.

You now have 50% of respondents who actually never used it a single time, but your survey results will show as having used it as many as 10 times. The result is a completely inaccurate data set.




Andrew Nelson said:


> I am curious what would be unethical about giving 0.5 mg just to rule out a possible cause? Is it not given in codes with unknown etiology?



Are we talking about cardiac arrests where opioid OD is a potential cause, or more general circumstances where "they are stumped", as you put it?

It is one thing to give it to a 20 year old male cardiac arrest victim where no other etiology is apparent and opioid OD is therefore a plausible or even likely cause, and in which case you are using the naloxone as a potentially useful therapy, not as a diagnostic tool.

It is a very different thing to give it indiscriminately to everyone whose depressed state is of unknown cause - just to see if it works, which is the approach that your survey suggests.



Andrew Nelson said:


> I originally came up with the topic because I witnessed ER doctors on more than one occasion ask EMS if they tried narcan to rule out narcotic overdose. If they had not they put in an order for it right away. *As you know the docs go through a tad bit more schooling.* So this sparked my idea that maybe it should be used more in the field to possibly help the doctors speed up treatment plans.



You are right, they do go through a tad bit more schooling. Which means that they may be giving it with an intentionality that you are not aware of, rather than for the reason that you presume to be the case. Or maybe they _are_ giving it as just a shotgun approach.

Either way I would be careful about assuming that something is the right thing to do just because you've seen someone with more education than you do it.


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## Andrew Nelson (Jul 3, 2016)

What intentionality would that be then? You can't just make unsubstantiated claims so that you can say that my inquiry is misguided. Also I'm curious why you're so against using it as a diagnostic tool. You've never given a reason. You just keep wagging your finger at me for gathering some opinions on the matter. 

As for the rest of your criticism, I don't think I'm not taking this seriously enough, I think you're taking this too seriously. It's a mandated assignment that is jammed into an already intensely busy semester and I work for a full time fire department. So time and energy have been hard to come by. I needed a topic and I was curious what other people thought about this topic after I witnessed multiple doctors' practices regarding it. I think it's a pretty harmless survey and you're reading way too into it. If people want to take the 30 seconds to answer the questions, great! If not, I think I'll sleep just fine at night. 

Also I'm aware I forgot a zero option. It was too late to redo it once I made the realization. Like I said, operating on fumes.


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## Tigger (Jul 3, 2016)

Andrew Nelson said:


> What intentionality would that be then? You can't just make unsubstantiated claims so that you can say that my inquiry is misguided. Also I'm curious why you're so against using it as a diagnostic tool. You've never given a reason. You just keep wagging your finger at me for gathering some opinions on the matter.
> 
> As for the rest of your criticism, I don't think I'm not taking this seriously enough, I think you're taking this too seriously. It's a mandated assignment that is jammed into an already intensely busy semester and I work for a full time fire department. So time and energy have been hard to come by. I needed a topic and I was curious what other people thought about this topic after I witnessed multiple doctors' practices regarding it. I think it's a pretty harmless survey and you're reading way too into it. If people want to take the 30 seconds to answer the questions, great! If not, I think I'll sleep just fine at night.
> 
> Also I'm aware I forgot a zero option. It was too late to redo it once I made the realization. Like I said, operating on fumes.


Turns out paramedic education programs are actual college classes, and require real academic work which also includes writing papers.


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## Andrew Nelson (Jul 3, 2016)

Hey captain obvious, Im not saying I disagree with doing the assignment. I'm saying I don't have the time or the energy to conduct an extensive research study worthy of being published.


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## DesertMedic66 (Jul 3, 2016)

Andrew Nelson said:


> Hey captain obvious, Im not saying I disagree with doing the assignment. I'm saying I don't have the time or the energy to conduct an extensive research study worthy of being published.


What everyone is saying is that if you are going to do an assignment and turn it in at least spend some extra time on doing a proper survey. 4 questions with not very good answer selections are not useful at all.


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## gotbeerz001 (Jul 3, 2016)

Andrew Nelson said:


> Hey captain obvious, Im not saying I disagree with doing the assignment. I'm saying I don't have the time or the energy to conduct an extensive research study worthy of being published.


Then just make the values up. That way you can have it conclude whatever you choose. Seems like you're putting TOO much effort into something that will be dog[poop].

Also, working full-time fire offers more (paid) time to study and dedicated time off than almost any other full-time job. Please do not add fuel to the fire of the proverbial lazy fire medic.


Sent from my iPhone using Tapatalk


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## Andrew Nelson (Jul 3, 2016)

Too much effort =dog[poop]? Make up values and cheat on my assignment instead? Great logic. Are you one of those lazy medics?

The assignment is to gather opinions on an EMS topic to spark conversation so that we can continue to improve our profession. My topic and the four questions fulfill the requirements perfectly. This isn't a graduate level program thesis.

Finally, I don't assume to understand your life and its demands or the quality of employee you are, so don't sit behind your keyboard and make assumptions about mine.


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## cprted (Jul 3, 2016)

I've never given naloxone as a diagnostic agent.  I give it when I suspect an opiod overdose to be the primary cause of the patient's hypoventilation.


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## Andrew Nelson (Jul 3, 2016)

STXmedic said:


> Out of curiosity, what's the goal of that survey?
> 
> Also, you don't have zero as an option for number of times.



The goal is to gather the rate at which medics have used narcan diagnostically, if they've seen success, and their opinion on protocols encouraging its use more in that fashion. It's for a paper that I need to write for school. The teacher likes the students to think of new ideas or issues that may spark conversation about changing and improving our progression.

Also my b on the zero. Realized it after the fact. I guess if you're a zero in that category then just don't complete the survey or skip that question.


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## Andrew Nelson (Jul 3, 2016)

cprted said:


> I've never given naloxone as a diagnostic agent.  I give it when I suspect an opiod overdose to be the primary cause of the patient's hypoventilation.



Thanks for your answer! See everyone else? That wasn't so hard.


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## DesertMedic66 (Jul 3, 2016)

For those that are wondering it took me 5 minutes and 11 seconds to make a survey....

https://www.surveymonkey.com/r/QHZRH2P


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## STXmedic (Jul 3, 2016)

Remi's point stands. You don't offer an option of zero- only 1-10. Your selections imply that using Narcan just because is something that everybody does, and you just want to know how often that is. The fact is, many (possibly even most) don't do that anymore. Opiates have a fairly specific presentation. If they meet that presentation and suspicion, they get Narcan. They don't get narcan just because they're unconscious/unresponsive/altered.

And in regards to cardiac arrest, that's also old practice. What role does Narcan play in cardiac arrest? What is the indication for Narcan during a standard opiate overdose prior to arrest? Narcan is intended to restore respiratory effort. Do you know what else fixes the hypoxia and hypoventilation? A BVM. Thus Narcan is not needed at any point during a cardiac arrest.

What people are trying to point out is that your survey is worded poorly, thus skewing the results and altering the productive discussion you're hoping for. That's not going to "improve our profession" in any way. All it's doing is propagating old, outdated dogma that many are trying to fight.


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## DesertMedic66 (Jul 3, 2016)

Andrew Nelson said:


> Also my b on the zero. Realized it after the fact. I guess if you're a zero in that category then just don't complete the survey or skip that question.


I wasn't able to just skip the question. The survey made me answer all questions before I could click the finish button. You are still able to edit the survey to include 0 as an answer. 

If you want to gauge how often medics use Narcan as a diagnostic tool only then saying "skip that question" is going to give you a very biased answer base.


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## Andrew Nelson (Jul 3, 2016)

Thank you for stating your opinion! I'll add it to the responses. You could have just taken the survey and hit the "strongly disagree" option for the last question and saved yourself some time.


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## Andrew Nelson (Jul 3, 2016)

DesertMedic66 said:


> I wasn't able to just skip the question. The survey made me answer all questions before I could click the finish button. You are still able to edit the survey to include 0 as an answer.
> 
> If you want to gauge how often medics use Narcan as a diagnostic tool only then saying "skip that question" is going to give you a very biased answer base.



My apologies, this was my first time using survey monkey's services.


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## Carlos Danger (Jul 3, 2016)

Andrew Nelson said:


> You can't just make unsubstantiated claims so that you can say that my inquiry is misguided.



Exactly what unsubstantiated claim did I make?

You are the one who tried to justify this practice by pointing out that "the ED physicians have a lot more training than we do", as though that means that everything you see done by every EM doc should be mimicked by every paramedic. I simply took your (true) statement in a slightly different direction and pointed out that, because they have much more training than you do, maybe they have reasons for doing things that you aren't aware of. You don't know what you don't know.

You can't hide behind the "but the docs do it and they know more than us" deal when it works in your favor and then run from it when someone suggests that maybe they are more qualified to make a certain decision than you are.



Andrew Nelson said:


> I'm curious why you're so against using it as a diagnostic tool.



Because it is just sloppy medicine.

The "coma cocktail" used to be common, but fell out of favor when we learned that it doesn't work. We also used to inject epi into the heart, compressed the lower torso to increase BP, and strapped people's entire bodies to hard boards in case their neck was injured. Before that we drained "bad humors" from sick people and literally blew smoke up people's butts in an attempt to regain a pulse. We stopped doing those things, too, when we realized that they didn't work.

Instead of using a poorly worded survey to fish for opinions that support your beliefs, try reading the actual clinical research on the topic.



Andrew Nelson said:


> As for the rest of your criticism, I don't think I'm not taking this seriously enough,



You'r words: "I just have to put some numbers on a paper with some words". Forgive me if I misinterpreted that when what it really meant was that you were trying hard to to a good job.


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## Andrew Nelson (Jul 3, 2016)

STXmedic said:


> Remi's point stands. You don't offer an option of zero- only 1-10. Your selections imply that using Narcan just because is something that everybody does, and you just want to know how often that is. The fact is, many (possibly even most) don't do that anymore. Opiates have a fairly specific presentation. If they meet that presentation and suspicion, they get Narcan. They don't get narcan just because they're unconscious/unresponsive/altered.
> 
> And in regards to cardiac arrest, that's also old practice. What role does Narcan play in cardiac arrest? What is the indication for Narcan during a standard opiate overdose prior to arrest? Narcan is intended to restore respiratory effort. Do you know what else fixes the hypoxia and hypoventilation? A BVM. Thus Narcan is not needed at any point during a cardiac arrest.
> 
> What people are trying to point out is that your survey is worded poorly, thus skewing the results and altering the productive discussion you're hoping for. That's not going to "improve our profession" in any way. All it's doing is propagating old, outdated dogma that many are trying to fight.



I've already stated why I chose the topic so if you know more than the ER doctors I observed then good on you bud. 

I've already stated it was my error I left out a zero option. 

I've already stated the questions meet the requirements for the assignment. My teacher who has completed his doctorate in health sciences and has worked in EMS for many years appreciated the topic and found value in gathering others opinions. I don't know you from Adam so I appreciate your opinion but I'll continue with the paper as is. 

Also the responses collected so far have been split. It seems people have given it diagnostically and they have had positive outcomes. You choose not to and that is your prerogative.


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## Andrew Nelson (Jul 3, 2016)

Remi said:


> Exactly what unsubstantiated claim did I make?
> 
> You are the one who tried to justify this practice by pointing out that "the ED physicians have a lot more training than we do", as though that means that everything you see done by every EM should be mimicked by every paramedic. I simply took your (true) statement in a slightly different direction and pointed out that, because they have much more training than you do, maybe they have reasons for doing things that you aren't aware of. You don't know what you don't know.
> 
> ...



I apologize for using jovial language. I thought this would be a light hearted forum where I could gather some data for a paper. I was unaware I would receive such a lambasting from the worlds smartest medics. Glad I don't have to work with folks like you. 

My topic and questions were approved my teacher who has completed his doctorate and worked in EMS for many years and he found value in researching further so I'll stick with what I have. The responses have been varied already anyways so clearly not everyone is onboard with your train of thought. I'm not going to go back and forth with you because I clearly will not be changing any minds. I value your opinion and thanks for sharing it.


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## cprted (Jul 3, 2016)

50% of people surveyed say they use naloxone as a diagnostic agent ... does that mean they're right?  Not very high quality data.   Medical practice shouldn't be guided by popular opinion.  

How about doing some reading into what naloxone actually does ... like going deeper than 'competitively antagonizes opioid receptors.'  Any other actions? Yes it is a "safe drug," but what are the risks and possible complications of giving naloxone to a polypharm OD?  Can naloxone have an effect on people with no opioid in their body, but suffering the effects of another toxidrome?  Is an increase in LOC following naloxone administration pathognomonic for opioid overdose?


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## Andrew Nelson (Jul 3, 2016)

cprted said:


> 50% of people surveyed say they use naloxone as a diagnostic agent ... does that mean they're right?  Not very high quality data.   Medical practice shouldn't be guided by popular opinion.
> 
> How about doing some reading into what naloxone actually does ... like going deeper than 'competitively antagonizes opioid receptors.'  Any other actions? Yes it is a "safe drug," but what are the risks and possible complications of giving naloxone to a polypharm OD?  Can naloxone have an effect on people with no opioid in their body, but suffering the effects of another toxidrome?  Is an increase in LOC following naloxone administration pathognomonic for opioid overdose?



Those are all fantastic questions to raise. They would probably be the follow up questions to the survey I presented. The survey was an initial gauge of current use and successes. The data is available so why not consider it and then determine if we need to further look into the medications actions and interactions to see if it actually a "safe drug" like we are told.


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## WolfmanHarris (Jul 3, 2016)

I can't help but get a kick out of this. My Advanced Care Paramedic course coming up this fall has a full course devoted to research methods. 

My employer has an entire unit devoted to research. One of our Paramedics has a PhD earned doing research in Paramedic education. A few of our medics also have or are working on Msc's doing clinical research. 

By 2025 it's expected that entry to practice for Paramedics will be a four year Bachelor's in Canada. 

Research is vital to advancing this profession and Paramedic lead research is key to having control over the direction this profession takes in the future. Paramedicine isn't an extra cert for an FF to toss on their resume along with rope rescue and hazmat ops and shouldn't be treated as such.


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## Carlos Danger (Jul 3, 2016)

Andrew Nelson said:


> Those are all fantastic questions to raise. They would probably be the follow up questions to the survey I presented. The survey was an initial gauge of current use and successes. *The data is available so why not consider it* and then determine if we need to further look into the medications actions and interactions to see if it actually a "safe drug" like we are told.



That's right, the data is already available. Everything you could ever want to know about narcan is right there for the reading. Including whether it's a good practice to give it indiscriminately.

P.S., I think it is fascinating that you still think this survey is a "gauge" of anything.


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## Andrew Nelson (Jul 3, 2016)

WolfmanHarris said:


> I can't help but get a kick out of this. My Advanced Care Paramedic course coming up this fall has a full course devoted to research methods.
> 
> My employer has an entire unit devoted to research. One of our Paramedics has a PhD earned doing research in Paramedic education. A few of our medics also have or are working on Msc's doing clinical research.
> 
> ...





Remi said:


> That's right, the data is already available. Everything you could ever want to know about narcan is right there for the reading. Including whether it's a good practice to give it indiscriminately.
> 
> P.S., I think it is fascinating that you still think this survey is a "gauge" of anything.



Link to the studies then please. Don't just claim they are out there and that they support your position so you can make slighted comments.


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## cprted (Jul 3, 2016)

https://scholar.google.ca/scholar?as_ylo=2016&q=naloxone&hl=en&as_sdt=0,5

3,480 articles published since the beginning of 2016 ...


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## Andrew Nelson (Jul 3, 2016)

cprted said:


> https://scholar.google.ca/scholar?as_ylo=2016&q=naloxone&hl=en&as_sdt=0,5
> 
> 3,480 articles published since the beginning of 2016 ...


Thanks! I'll definitely dive into those! But I would like Remi to post specific studies stating founded reasons supporting his stance.


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## NomadicMedic (Jul 3, 2016)




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## Tigger (Jul 4, 2016)

Andrew Nelson said:


> Hey captain obvious, Im not saying I disagree with doing the assignment. I'm saying I don't have the time or the energy to conduct an extensive research study worthy of being published.


Nor am I suggesting that. But to make a survey, give it to a very limited audience, and then use it to draw any sort of inclusions is not how even the most basic research works. There is research out there on this topic if you look for it. My program and every other paramedic program I am familiar required a few research papers throughout the year, and one of the biggest goals of these assignments is to get people used to looking up and analyzing published research to support or reject practices..."creating" your own data is not how you do that.


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## Summit (Jul 4, 2016)

Andrew Nelson said:


> Thanks! I'll definitely dive into those! But I would like Remi to post specific studies stating founded reasons supporting his stance.


You want other people to give a lot more effort than you are willing to give. I bet your instructors see that too.

Reiterating what other said, I didn't submit results because my responses weren't any of the options.


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## MMiz (Jul 4, 2016)

I think the group is being too harsh.  

If I Google my old usernames I can find the time I did a survey on the death penalty my freshman year in college along with a few other surveys i hastily created to meet course requirements.  These sort of assignments are mainstays on EMS programs.

I'm not sure it's fair to expect the typical EMS student to develop effective, scientific surveys and questionnaires.


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## Andrew Nelson (Jul 4, 2016)

Summit said:


> You want other people to give a lot more effort than you are willing to give. I bet your instructors see that too.
> 
> Reiterating what other said, I didn't submit results because my responses weren't any of the options.



I've never had less than a 93 average in any of the didactic sections along with perfect marks in my field work all year long. 

Requesting sources of studies he's claiming exist so that he can belittle me on an Internet thread is not asking much at all. 

If you don't fit into the survey, do not fill it out.


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## Andrew Nelson (Jul 4, 2016)

Tigger said:


> Nor am I suggesting that. But to make a survey, give it to a very limited audience, and then use it to draw any sort of inclusions is not how even the most basic research works. There is research out there on this topic if you look for it. My program and every other paramedic program I am familiar required a few research papers throughout the year, and one of the biggest goals of these assignments is to get people used to looking up and analyzing published research to support or reject practices..."creating" your own data is not how you do that.




That is exactly what your statement implied. I am actually going above and beyond what was required by posting the survey on this forum and gathering answers from medics in other states and regions. We were told to just survey our local departments.

I think this is part of the disconnect with you people. You're assuming you know exactly what the assignment required. We were not told to analyze previous research to draw conclusions. The point was to survey already working medical providers on an approved topic so that we could have some conversations about some contested topics. 

Y'all are a hoot though. Truly a wealth of useless feedback.


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## Andrew Nelson (Jul 4, 2016)

MMiz said:


> I think the group is being too harsh.
> 
> If I Google my old usernames I can find the time I did a survey on the death penalty my freshman year in college along with a few other surveys i hastily created to meet course requirements.  These sort of assignments are mainstays on EMS programs.
> 
> I'm not sure it's fair to expect the typical EMS student to develop effective, scientific surveys and questionnaires.





DEmedic said:


> View attachment 2885





DEmedic said:


> View attachment 2885





MMiz said:


> I think the group is being too harsh.
> 
> If I Google my old usernames I can find the time I did a survey on the death penalty my freshman year in college along with a few other surveys i hastily created to meet course requirements.  These sort of assignments are mainstays on EMS programs.
> 
> I'm not sure it's fair to expect the typical EMS student to develop effective, scientific surveys and questionnaires.



Or to assume the expectations and requirements of the assignment. This one happens to fall into the "hastily created to meet course requirements" on both the teacher and student side. Given more time and resources and had the assignment laid out more stringent guidelines the survey would have been more thorough.


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## NomadicMedic (Jul 4, 2016)

Wait, I think I'm confused.

Let me see if I've got this right...

The OP constructed a bias based survey with poor options to allow for any real data collection. When he was called out on it he replied,


Andrew Nelson said:


> It's for my third semester of paramedic school so needless to say I just need some numbers to throw on a paper with some words.



And now the the forum is being to harsh?

Please. Patting everyone on the head and saying, "it's okay honey, I know you tried" disgusts me. Do the work correctly and when someone calls you out for not doing it right, don't get defensive and try to talk your way out of it.
And @MMiz, just because you once did some "hastily constructed surveys", that means you give him a dispensation and its okay? How is that valid? Because you shoplifted once, that means it's okay if I do it?

When you show up in a group of EMS professionals, you should be able to handle criticism when you start to spout off. "We don't suffer fools gladly" fits this whole discussion to a T.


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## Carlos Danger (Jul 4, 2016)

Andrew Nelson said:


> Thanks! I'll definitely dive into those! But I would like Remi to post specific studies stating founded reasons supporting his stance.



I'm done with school for now, and I'm not doing your homework for you. Sorry.

Suffice it to say there are _reasons_ why this practice used to be common but is now frowned upon in most circles. Naloxone is a very safe drug when given for it's intended indications, but when given indiscriminately just because you don't know why someone is unresponsive.....not as safe, and usually ineffective. Do your own research to figure out why - that list that cprted linked for you is probably a good place to start. I am already intimately familiar with the drug and how it works and not in need of a refresher yet.



Andrew Nelson said:


> Y'all are a hoot though. Truly a wealth of useless feedback.



You are a freakin' paramedic student, get off your high horse. Some of the people here have been practicing since you were in diapers, and have forgotten more than you've learned so far. The ones who haven't been doing it that long are still a smart bunch with solid experience and generally a good appreciation for EBM. You'd be wise to listen more and spout off less.


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## Nova1300 (Jul 4, 2016)

Just as a starting point, Andrew- asking someone how many times in their career they have provided a therapy is a question which will be subject to a great deal of inaccuracy.  This is called "recall bias."  Unfortunately, your survey will be almost entirely composed of data which is made up by the people answering the question.  That's not even a real survey, much less a study.  

Maybe re-write focusing on providers' attitudes regarding narcan as a diagnostic tool, without asking the question "how many times have you ..."

This really could be a simple, easy survey reflecting people's attitudes about the practice.  But you will need to spend a few minutes developing questions which actually lead to non-predetermined conclusions.  This still should not take long.  

Part of the pushback your are getting is about pride in the profession.  If paramedicine is to move toward the arena of research and practice improvement, the onus is on the new generation to care about data collection and interpretation.  And, you are part of the new generation.  If you want to stay up to date in the field after certification, it would really be helpful to have some understanding of how to read and interpret basic research.  Because the prehospital and emergency medicine literature is still very much in its infancy, this is an exciting time for EMS.   I'm sorry if your instructor doesn't feel that way, but there are many, many medical directors in this country that do. 

Definitely get the assignment done, but really this stuff is important and will only become more so in the future.


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## Tigger (Jul 5, 2016)

MMiz said:


> I think the group is being too harsh.
> 
> If I Google my old usernames I can find the time I did a survey on the death penalty my freshman year in college along with a few other surveys i hastily created to meet course requirements.  These sort of assignments are mainstays on EMS programs.
> 
> I'm not sure it's fair to expect the typical EMS student to develop effective, scientific surveys and questionnaires.


Developing your own research is very rare in any EMS course (or undergrad for that matter). It's for good reason, doing so is difficult and requires actually knowing how develop surveys and other data collection apparatuses. If in fact the assignment was to develop one's own data, that's absurd. 

Being able to analyze studies is a big part of medicine, yet the OP seems to have no willingness to let us impose that point.


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## Tigger (Jul 5, 2016)

Andrew Nelson said:


> That is exactly what your statement implied. I am actually going above and beyond what was required by posting the survey on this forum and gathering answers from medics in other states and regions. We were told to just survey our local departments.
> 
> I think this is part of the disconnect with you people. You're assuming you know exactly what the assignment required. We were not told to analyze previous research to draw conclusions. The point was to survey already working medical providers on an approved topic so that we could have some conversations about some contested topics.
> 
> Y'all are a hoot though. Truly a wealth of useless feedback.


You're sterling credentials are truly shining through. No one is attacking you, yet all you choose to do is come down on the people who are right to point out that the "survey" in question provides nearly nothing of use.


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## RocKetamine (Jul 5, 2016)

Not sure why it would be so hard to remake the survey to be less biased towards the answer you're looking for. Anyways, I've never used it for a diagnostic tool and it shouldn't be used as one.


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## Andrew Nelson (Jul 6, 2016)

Nova1300 said:


> Just as a starting point, Andrew- asking someone how many times in their career they have provided a therapy is a question which will be subject to a great deal of inaccuracy.  This is called "recall bias."  Unfortunately, your survey will be almost entirely composed of data which is made up by the people answering the question.  That's not even a real survey, much less a study.
> 
> Maybe re-write focusing on providers' attitudes regarding narcan as a diagnostic tool, without asking the question "how many times have you ..."
> 
> ...



I genuinely appreciate your response. I was not trying to disrespect the veteran folks in the field. My push back was the insulting way in which many went about it. I practice common curtesy but respect is earned in my opinion, not a given. 

In regards to the assignment, I really think there was/ is a misunderstanding on the depth and detail it was suppose to entail. I've always taken pride in being open to learning and listening to those wiser and more experienced than me but I cannot learn from belittling insults. You and one other responder have been the only ones to give actual constructive criticism so I sincerely thank you.

I will definitely be taking the time after I finish school to completely learn all there is to know about  Narcan and the proper way to survey for this kind of research. It was not my intention to come off as biased. I had limited questions so I chose the ones that would be the most useful for completing the assignment. 

As much as I know it will mean little via Internet text, I truly have a lot of respect for our profession and want to see it develop into the best it can be. I chose my career because I wanted to improve the lives of those around me and I now see that this will include aiding those who shape our practices so that we can appropriately evolve. 

Cheers and be safe.


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## Andrew Nelson (Jul 6, 2016)

Tigger said:


> Developing your own research is very rare in any EMS course (or undergrad for that matter). It's for good reason, doing so is difficult and requires actually knowing how develop surveys and other data collection apparatuses. If in fact the assignment was to develop one's own data, that's absurd.
> 
> Being able to analyze studies is a big part of medicine, yet the OP seems to have no willingness to let us impose that point.



So then your issue is with the assignment. If I haven't made it clear already, I recognize the existence and relevance of previous studies.  We were told to gather our own unique responses on a chosen topic and analyze them.


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## sack jears (Jul 24, 2016)

Lotta people playing holier than thou with this thread. Help him with his survey or don't


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## DesertMedic66 (Jul 24, 2016)

sack jears said:


> Lotta people playing holier than thou with this thread. Help him with his survey or don't


We are giving him advise to help with his survey. No one on this form wants to take a flawed survey.


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## Tigger (Jul 24, 2016)

sack jears said:


> Lotta people playing holier than thou with this thread. Help him with his survey or don't


Sort of like you are doing here?

The reality is that research not done right is not research at all.


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## sack jears (Jul 28, 2016)

Tigger said:


> Sort of like you are doing here?
> 
> The reality is that research not done right is not research at all.


I mean he just needed help with a project and dude's kind of getting blasted. Just a lot of excessive responses so far.


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## RocKetamine (Jul 28, 2016)

sack jears said:


> I mean he just needed help with a project and dude's kind of getting blasted. Just a lot of excessive responses so far.



No one blasted him until he got an attitude.


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## sack jears (Jul 28, 2016)

RocKetamine said:


> No one blasted him until he got an attitude.


Alright well my bad then


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## Andrew Nelson (Jul 30, 2016)

Thanks for trying to help sack jears. These fellas just chose not to understand I was following specific instructions from my instructor.

I ended up with enough responses and got 100% on the assignment, a 95.59% for the third semester, and a 4.0 for the year. I guess I did something right.


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## NomadicMedic (Jul 30, 2016)

Congratulations. You sure showed us.


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## Carlos Danger (Jul 30, 2016)

Andrew Nelson said:


> I ended up with enough responses and got 100% on the assignment, a 95.59% for the third semester, and a 4.0 for the year. I guess I did something right.


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## gotbeerz001 (Jul 30, 2016)

In general, good medics did well in school. 

Doing well in school does not necessarily guarantee that you will be a good medic. 

Cutting corners is one of those things that people can get away with for years.... until they don't. 

While you may end up being a solid medic, the know-it-all attitude that you displayed here will be one of those X-factors which leads to strained relationships with preceptors, partners and patients. Getting good grades is the easy part. 

Just my $0.02


Sent from my iPhone using Tapatalk


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## StCEMT (Jul 30, 2016)

I'd have done your survey, but since I couldn't answer some of it I didn't. I get it. School is busy. I am in third semester too. But I have 5 minutes to correct a survey that could have led to an interesting discussion. I dont need a hand to count my diagnostic use of Narcan. I could use a hand to count the people I haven't given it to the past month alone who I knew had opiates in their system. I haven't really felt a need to try it yet just to see what happens.


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## gotbeerz001 (Jul 31, 2016)

StCEMT said:


> I could use a hand to count the people I haven't given it to the past month alone who I knew had opiates in their system. I haven't really felt a need to try it yet just to see what happens.


That's the point... you give Narcan when indicated. I don't give Narcan to reverse opiate OD; I give it to correct respiratory depression secondary to suspected opiate OD. 


Sent from my iPhone using Tapatalk


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## Andrew Nelson (Jul 31, 2016)

DEmedic said:


> Congratulations. You sure showed us.





gotshirtz001 said:


> In general, good medics did well in school.
> 
> Doing well in school does not necessarily guarantee that you will be a good medic.
> 
> ...



Except that attitude wasn't displayed. I conceded that I made errors in the survey, recognized the study was not complete, and tried to convey that I was aware previous studies were relevant but that my teacher specified only wanting responses gathered by us for the assignment. I was very respectful to those who gave me actual constructive criticism. Read back through the thread if you'd like.

I appreciate your $0.02 and the concern. As I stated before, I do love our profession and respect the unique position were in as public servants. I'm sorry if some of my responses left a bad taste but I was not taught to take adversity lying down, on my back. You all would rather I just concede at every turn and just assume you all know best without question. Where's the growth in that? 

I know they're just words because we can't convey things like work ethic and character over the Internet but I promise the profession is in good hands. 

Have a nice Sunday, cheers.


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## gotbeerz001 (Jul 31, 2016)

Andrew Nelson said:


> Thanks for trying to help sack jears. These fellas just chose not to understand I was following specific instructions from my instructor.
> 
> I ended up with enough responses and got 100% on the assignment, a 95.59% for the third semester, and a 4.0 for the year. I guess I did something right.


This unsuccessful attempt to show you were right is part of the attitude I am talking about... As you can see, no one is impressed.

Good job getting 100% "throw(ing) numbers on a paper with some words". You'll be fine. 


Sent from my iPhone using Tapatalk


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## Andrew Nelson (Jul 31, 2016)

gotshirtz001 said:


> This unsuccessful attempt to show you were right is part of the attitude I am talking about... As you can see, no one is impressed.
> 
> Good job getting 100% "throw(ing) numbers on a paper with some words". You'll be fine.
> 
> ...




I was not trying to impress anyone. I've been trying to convey that I was following specific instructions this whole time. 100% means I followed them correctly. The rest was to prove that I didn't deserve to be spoken to like an idiot as many have done on this thread. Sticking up for yourself is now attitude? Thanks a lot Obama.

But I concede. I tried to make nice and you can't let it go.


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## Summit (Jul 31, 2016)

Andrew Nelson said:


> I tried to make nice and you can't let it go.


weird political non sequitur aside

I came here to say you clearly haven't  learned to eat crow, but you had better learn to let things go. 

You will probably end up learning this the hard way. EMS will provide that experience.


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## Andrew Nelson (Jul 31, 2016)

Summit said:


> weird political non sequitur aside
> 
> I came here to say you clearly haven't  learned to eat crow, but you had better learn to let things go.
> 
> You will probably end up learning this the hard way. EMS will provide that experience.


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## Tigger (Aug 1, 2016)

Andrew Nelson said:


> I was not trying to impress anyone. I've been trying to convey that I was following specific instructions this whole time. 100% means I followed them correctly. The rest was to prove that I didn't deserve to be spoken to like an idiot as many have done on this thread. Sticking up for yourself is now attitude? Thanks a lot Obama.
> 
> But I concede. I tried to make nice and you can't let it go.


Who is talking to you like an idiot?


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## paramed72 (Aug 3, 2016)

Andrew Nelson said:


> Hey captain obvious, Im not saying I disagree with doing the assignment. I'm saying I don't have the time or the energy to conduct an extensive research study worthy of being published.


So......when you get tired and exhausted from multiple calls, are you going to not have the energy to perform a thorough patient exam?


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