Narcan for EMT basics, cops, firefighters

[zzyzx]

Has your county allowed EMT basics, cops, and/or firefighters to administer Narcan?

If so, any stats on how often it has been used and if there is any evidence of lower OD deaths?

 

[hometownmedic5]

Emts, cops, fire, hell you can buy it over the counter in mass now. Everybody has it, and uses it frequently. As for frequency, daily. Every single day. Usually it's administered correctly too.

Of course we're seeing a reduction in od deaths. That's the whole point of narcan. I almost never show up to a patient still unresponsive anymore. They're almost always up and talking by the time I get there. Whether the availability of narcan is ultimately a good thing is up for debate, but they're definitely dying less now that everybody has narcan.

 

[zzyzx]

Emts, cops, fire, hell you can buy it over the counter in mass now. Everybody has it, and uses it frequently. As for frequency, daily. Every single day. Usually it's administered correctly too.

Of course we're seeing a reduction in od deaths. That's the whole point of narcan. I almost never show up to a patient still unresponsive anymore. They're almost always up and talking by the time I get there. Whether the availability of narcan is ultimately a good thing is up for debate, but they're definitely dying less now that everybody has narcan.

Do you have any stats from you county showing how often it has been administered by basics, cops, firefighters? Thanks

 

[EpiEMS]

Do you have any stats from you county showing how often it has been administered by basics, cops, firefighters? Thanks

Here's three examples from Mass:

"In 2013, the Boston EMS service responded to 1207 overdose calls, and EMTs administered naloxone in 458 cases."

"Between 2010 and 2013, Quincy police administered naloxone 201 times"

"Between 2010 and 2013, Revere firefighters administered naloxone 114 times."

Has your county allowed EMT basics, cops, and/or firefighters to administer Narcan?

If so, any stats on how often it has been used and if there is any evidence of lower OD deaths?

Yup, CT allows for it. As does NY.

I have not personally had the chance to administer naloxone. However, as I mentioned earlier, there is good evidence that it is being used frequently even in smaller cities (Quincy and Revere, MA). Heck, here's another study, where they cite harm reduction programs for users:

"By June 2014, 644 local programs in 30 states and Washington, D.C. were responsible for the distribution of 152,283 naloxone kits and 26,453 overdose reversals."

And another...pretty small n, but, you know, I'll take what I can get:

"Data from 247 individuals were eligible for study inclusion. Opioid overdose deaths increased significantly before initiation of the police officer NPP with average deaths per quarter of 5.5 for 2011, 15.3 for 2012, and 16.3 for the first 9 months of 2013. After initiation of the police officer NPP, the number of opioid overdose deaths decreased each quarter with an overall average of 13.4. Of the 67 participants who received naloxone by police officers, 52 (77.6%) survived, and 8 (11.9%) were lost to follow-up."

 

[hometownmedic5]

Do you have any stats from you county showing how often it has been administered by basics, cops, firefighters? Thanks

I don't have access to the data, but the majority of our extensive overdoses get narcan from somebody other than a paramedic.

 

[EpiEMS]

I don't have access to the data, but the majority of our extensive overdoses get narcan from somebody other than a paramedic.

I wouldn't be surprised if, at the end of the day, once most EMTs in the U.S. start carrying naloxone, that most OD patients will be getting naloxone from a non-ALS provider.

 

[hometownmedic5]

I would agree. I almost never give it anymore, maybe 10% of the overdoses I go to get narcan from me.

For me, it's not so much the Emts since we don't run primary bls units in my town. It's PD/FD. They almost always beat us to the scene and blast them with their super concentrated narcan. All I typically do is dump a line and transport.

 

[DesertMedic66]

EMTs, no. Cops, not that I have heard off. Firefighters, only the paramedic firefighters.

We really don't have a huge opiate problem here so we don't get many times where we would use it. We mostly deal with meth.

 

[zzyzx]

Thanks for all the replies!

 

[Tk11]

Everyone carries it here, cops, firefighters, emts/medics, even he heroine addicts and the heroine addicts friends

 

[hometownmedic5]

Everyone carries it here, cops, firefighters, emts/medics, even he heroine addicts and the heroine addicts friends

You have an abundance of female superheroes? And they have friends? Awesome!

 

[Tk11]

You have an abundance of female superheroes? And they have friends? Awesome!

Lmao oops, heroin**

 

[StCEMT]

STLFD firefighters carry it now. 4mg right up the nose. Needless to say, I haven't given Narcan in a while. It gets used a lot.

 

[FirelineMedic103]

STLFD firefighters carry it now. 4mg right up the nose. Needless to say, I haven't given Narcan in a while. It gets used a lot.

4mg right off the bat? How about 1-2mg and see how they do. 4mg will obviously wake them up but if BLS providers can be gentle with the administration, the ALS units are going to like you alot more when they show up [emoji16]


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[VentMonkey]

How about 0.5 mg increments titrated to an adequate respiratory drive?

 

[hometownmedic5]

4mg right off the bat? How about 1-2mg and see how they do. 4mg will obviously wake them up but if BLS providers can be gentle with the administration, the ALS units are going to like you alot more when they show up [emoji16]


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FD/PD and our bls here have the new, super concentrated one step nasal sprays. 4mg in 0.1ml. It's a one shot deal. You cant tittrate it.

https://www.narcan.com

Ive given a boatload of narcan and honestly probably less than 5 percent wake up and cause problems. I dont know where the ingrained, non negotiable idea of the angry combative ill kill you all type of overdose revival came from, but that has not been my experience through many many overdoses.