What's your relationship like your local LEO's, and how well are your BLS providers taking to the protocol? Are they doing a better job than LE seems to be doing regarding judgement, and restraint with when to properly administer the Narcan?
I've seen it happen once, on an accidental OD on prescribed pain meds.... unfortunately, the patient happened to be a former linebacker and current LEO, so it was not fun during the first 30 seconds, but once he realized what happened, he was fine and grateful that we were there to keep him breathing and alive.
Probably similar to mine: good guys, good at the LEO stuff, not so great at the medical side, but if they can save a life with narcan before EMS gets there, they will. They are also the types who go into house fires with a fire extinguisher and try to put the fire out before the fire department gets there.
I cringe when I read this...unskilled BVM use has killed a lot of people.
Generally pretty good. On a 100 man department we have probably 6ish current or former EMTs. But like @DrParasite said, their training has filled their heads with heroism and the media absolutely loves it. A headline a week "Local cops save man". We have been able to educate some, but its not uncommon to get radio updates of 1, 2, 3 narcans delivered prior to our arrival.
Right, I worry this would be a similar effect if our local LEO's and/ or fire first responders were given this (even some overzealous EMT's, though they're theoretically easier to remediate in-house).
When I first started out, our company only stocked nasal trumpets in the BLS first-in bags (no clue why). Well, I would always ask our supply techs for a stack and they were usually kind enough to wrap one in each size in a rubber band, and I would stuff it in my first-in bag (same with the bougies, but another medic kindly swiped that without hesitation). I must not have been the only one bugging because now they're in every jump bag, ALS and BLS.
I always teach students to use an adjunct whenever they are using a BVM. I typically start with an OPA, unless I think they are going to get better shortly (IE, an opiod OD or a witnessed arrest who arrests in front of me who i can shock immediately), then I might start with an NPA. Or if they have a gag reflex, it's NPA or two.
The last time I worked my way up the ladder. Got there and an off duty doc was bagging with positioning-->I got an OPA--> Then I replaced the OPA with an igel a a little later. For me it's most of the time, it just depends on if we are going straight to an SGA or not.
Although the exception rather than the norm in my limited experience, my last arrest is why I don't believe in jumping straight to intubation. You're awake? Cool, lets just pull this out.