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Ok, this should be a fun one.


EMTDenny

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Yeah i know, I wanted to make changes but I used up my edit....

Just so you know, you get more than one edit...it's only limited by time. At least, that is how it used to be. :D

(no edits...just double checking...twice.)

Edited by tcripp
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EDIT: Spend enough time on the scene for the narcan to wear off and let him go unconscious again. Load and go, and give another dose of narcan (if needed) once you are closer to the hospital.

Along this line of thinking anf treating pt.'s, when I'm presented with a pt. like the one in Dennys scenario, I will administer just enough naloxone to allow the pt. to maintain his/her own airway. I have never adminstered enough to bring them totally around. It is easier to transport them when they are still somewhat unconscious and the decision to transport or not is a non-issue.

Once during clinicals, the crew I was riding with was Medic/Intermediate. The EMT-I by what I want to believe was a mistake, slammed 2mg of narcan and the pt. became responsive enough to whoop his ass! I always thought it was an old wives tale when I heard the stories about the results of adminstering narcan to quickly. Right up until the time I witnessed it.

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Wow last I heard of fortral was when we stopped carrying it here in 1990 :D

Strangely some of our junkies use to inject crushed Talwin (pentazocine) and Ritalin, as a poor man's speed ball. It's possible that the expression "T+R's" stuck around after the Talwin was replaced with something else because it sounds funny if you say it really quickly a few times (as in " T and R's". However this irony seemed to be lost on the users themselves.

I'm going to look and try and found out when/if they stopped prescribing it.

Edit: still available in my old area. But I wouldn't be surprised if the term is being used generically for some combination of crushed pills with a stimulant and CNS depressant, much like depending who you talk to, a speedball is either heroin+coke or heroin+meth.

Edited by systemet
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Nubain and fortral were in mainstream use until 1990 when we got morphine; I suspect some of the now defunct hospital based services carried it for a little while afterwards.

I know the London Ambulance Service used it in the early-mid 1990s as well.

I've never used either prehospitally. I was a little surprised people inject it, as it doesn't seem like pentazocine is that strong an opiod compared to others that I'd expect to be more available. But it seems to have been something that's gone on for years in that region, probably due to a relative lack of cheap heroin until quite recently.

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Just so you know, you get more than one edit...it's only limited by time. At least, that is how it used to be. :D

(no edits...just double checking...twice.)

Maybe I am not allowed to edit more than once. I am still not able to edit. It's alright. Lesson learn.

While the conversation was going on during the orientation, all I could think of was sharing this with you guys. And hell, 48 replies within 24 hours, pretty impressive.

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