Love Boat/Chemical Restraints

[DWR]

Is anyone else dealing with this? Love Boat which is marijuana dipped in Formaldehyde is very similar to PCP and is pretty big in my neck of the woods. We've had a pretty big run with this stuff this year and have had some very unsavory patients. We all know everyone is different ranging from the "interesting" guy on the street to the 120 pound person that takes 5 police officers to subdue. We've been seeing allot of this stuff lately and I'm finding a wide variation of methods that I need to use to calm the situation. Most of the time it's just talking to the patient and finding some common ground. And then sometimes it's like running down (not literally) and sedating a wild animal (with Police assistance of course).

How do you guys handle it? Obviously its going to be case by case basis. We do allot of verbal deescalation where I work before we go to physical or chemical restraints. Which brings me to my next question about chemical restraints (in general)... We are able to do Haldol (5mg) or Ativan (2mg) separately without online orders. Are most of the systems asking for permission? We can also do a "B52" (50mg Benadryl, 5mg Haldol, 2mg Ativan, IM) if we essentially ask for it. I've used Versed IN in the past which works awesome!

 

[STXmedic]

We've got a few different drugs going around right now that often require sedation. Most of them will not verbally deescalate. We have standing orders for up to 10mg Versed, 20mg Valium, or 2mg/kg Ketamine (or all 3 if needed, which was the case for a crew recently).

 

[DesertMedic66]

We have standing orders for 2.5mg Versed IV/IN or 5mg Versed IM. With a single repeat dose for standing orders for excited delirium.

Anything else we have to call for orders

 

[cruiseforever]

Standing order for chemical restraints. Up to 5 mg Versed with or without 10 mg Haldol based on age and weight.
Ketamine 5 mg/kg. IM, 2mg/kg if IV in place. Need to call if more is needed.

Never heard of the Love Boat drug here. But now that I said that.

 

[chaz90]

I saw this a little bit a few years ago. Wasn't this being called "wet" originally?

Standing orders for up to 5 mg Versed IV/IM/IN with or without up to 5 mg Haldol. If we ask for more Versed for chemical restraint we will absolutely get it.

 

[NomadicMedic]

It was either "wet" or "sherm" on the west coast. It makes the user go zero to 100 real quick. Versed and Haldol is the answer.

 

[johnrsemt]

Put this can't be true; marijauna is non harmful.

 

[phideux]

Way back in the good old days, where I grew up, it was called Zambola.

 

[EMT11KDL]

I dont think I have seen this lately. We are dealing more with spice and cocaine right now. Versed usually works great.

With the "Love Boat" are you seeing ETOH with it? and/or Vomiting? Also does your local RSI protocol allow you to RSI for overdose? I know the area I use to work in which RSI was allowed (Unfortunately I am no longer in a RSI system) we could for overdose for airway protection. (Added per Edit) protocol was not just because patient had overdose patient must show some type of sign that they could not probably protect their own airway Altered Consciousness and vomiting with decreased gag reflex.

 

[Tigger]

Put this can't be true; marijauna is non harmful.

Wut. It's soaked in formaldehyde. Pretty sure if you smoke anything soaked in formaldehyde you're going to have a bad time.

 

[NomadicMedic]

Wut. It's soaked in formaldehyde. Pretty sure if you smoke anything soaked in formaldehyde you're going to have a bad time.

Put this can't be true; marijauna is non harmful.

I think he forgot to put that in sarcasm font

 

[Tigger]

I think he forgot to put that in sarcasm font

I guess my point is that this should not be conflated as a marijuana issue. We have had very little issue with legalizing marijuana in this state yet there are still many that believe it is some sort of killer drug. It is not, and has a "safety profile" on par with alcohol. While no drug is safe, those that enjoy marijuana as it is intended do not create issues in the slightest which I think makes a case for more states to consider allowing recreation use and sale.

 

[Smash]

Not something we see in my neck of the woods. However, we have standing orders for up to 40mg of midazolam and 4mg/kg of ketamine. More if we ask. We can RSI for pretty much anything, but it would be very rare to see RSI happening in this setting.