Heroin OD-Treat n Release or Transport

[G]

Is this the same issue as hypoglycemia or do
you handle it differently?

Do you transport opiate OD's if they wake up and wish to refuse further treatment? Or do you insist on transport?

I know medic who always transport opiate OD's, with police intervention if necessary,
and medical control support,under the premise that opiates are longer acting than Narcan and present potentially life threatening consequences, and someone under any residual effects of Heroin/opiates may be of questionable competence to sign a refusal.

Do you wake them up completely or just enough to breath and perfuse spontaneously?
(some published articles suggest the latter may be better management, minimizing hostile or violent behavior risk as well as the risk of withdrawal symptoms including seizures.)

Your thoughts?

G

NREMTP, Preceptor
"Open Minded to Alternative Approaches
to Medicine"

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These are my own thoughts/opinions; not necessarily those of my affiliations-YES,I THINK!

[DED1645]

Unlike diabetics, OD'ers are not a treat and release canidates. As you know that narcan is not a prolong drug and will wear off. Unless you are using the new drug which I don't recall the name of. OD's do need to be transported. Our local PD is quite cooperative and will place the PT in protective custody and we will transport anyway. As you know OD'ers wake up two ways. Calm and cool or want to fight their *sses off. And you also know the strength they can have is incredible. Again I'm not a medic. But we do work very closely w/ our ALS in S.Jersey. We have a Paramedic Affiliate course that most take and it helps you help the medics. I also would have to say I have worked w/ medics in three states and four counties in S.Jersey and Camden Co. medics are the best I've assisted yet!

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David DeCant
firefighter/NREMT-B
Originally Mantua,NJ
Presently Lindenwold,NJ(I'm not a member of any of this District's dept's.)

[fyrmedik]

Where I presently work, our protocols state that all opiate ODs have to be transported,by whatever means necessary, because as you know, Narcan is short-acting.

[smokeygirl]

I'm not a medic but I work very closly with them in my area so please for forgive me for intruding. Most of the medics that I work with will only push enough narcan to bring the Pt's resp up etc. but not enough to bring up their LOC so they will not become combative. As most of you know the back of the rig isn't a fun place to be fighting with a Pt. Heroin OD's are done 1-2 times a day and more so at night. What a wonderful city to work in!!