Nate Posted May 2, 2006 Share Posted May 2, 2006 Don't speak for all, here in Las Vegas, we've gotta give it like candy. The opiate use in this town is off the charts. Protocols call for 2mg initial dose, but most of us are intelligent enough to start at a quarter of that and use just enough to get them out of respiratory depression, not completely conscious again. Believe it or not, I also used it twice in my last month in small-town New England... you just never know. Yup, it is used just about on a daily basis donw here as well. Link to comment Share on other sites More sharing options...
akroeze Posted May 2, 2006 Share Posted May 2, 2006 Hammer, I think you just proved exactly why BLS personnel should not have access to ALS meds ... If 2 mg of Narcan hasn't shown a response, either every potential receptor is already occupied, or there's something much more serious going on. If that's the case, securing the airway and maintaining adequate ventilations is now my top priority. Not that it wasn't before, but as I previously stated, if I can eliminate the problem, I will. The line of thinking of "well if 2 mg isn't enough, I'll just call for more" is a little skewed. And yes, I do know of patients who've received much more, but that was in-hospital with a lot more resources available. Yes, narcan has a shorter half-life then opiates. However, it is an antagonist, meaning, it will compete for receptor sites. If there's still sites available, it will bind to them, lessening the effects of whatever the patient took essentially by having less receptors for it to bind to and letting the others already bound wear off. Sorry if I'm not making things clear ... peace I think the point was... you give 2mg and they come around good... it starts to wear off and they go down hill yet you wouldn't call to get them out of it again? Link to comment Share on other sites More sharing options...
JPINFV Posted May 2, 2006 Share Posted May 2, 2006 The situation Lith gave was, "You give 2mg and nothing happens." Hammer is thinking, "Well, if 2mg isn't enough, then lets try 4." In this case, more isn't better. Quick key term check. "Antagonist" is the same thing as a "competitive inhibitor," correct? Link to comment Share on other sites More sharing options...
Lithium Posted May 2, 2006 Share Posted May 2, 2006 akroeze, thanks for pointing that out. I was taking it the wrong way. :? Honestly, I can't say. I've never been in that situation, and I can't see it being that plausible where I work. Even though Narcans half life is shorter then most opiates, it's still pretty long. 45 minutes or so, and 2 mg should be more then enough to last the time to hospital. However, if for whatever reason, I needed more because it was having an effect but began wearing off, I would definitely call for more. peace Link to comment Share on other sites More sharing options...
Lithium Posted May 2, 2006 Share Posted May 2, 2006 JPINFV, drop the 'competitve'. Antagonist in its truest form means "that which counteracts the action of something else". There's subtypes of antagonism as follows: competitive antagonist has an affinity for the receptor almost as much as the agonist and is reversible noncompetitive antagnoist completely blocks the agonist, and is irreversible. clear as mud? peace Link to comment Share on other sites More sharing options...
JPINFV Posted May 2, 2006 Share Posted May 2, 2006 Yep, got it. Just never heard those specific terms before. Link to comment Share on other sites More sharing options...
firemedic78 Posted May 2, 2006 Author Share Posted May 2, 2006 all the comments about EMT-I's wanting to get access to 'more drugs' without higher education is the main focus for all the Paramedics on this thread. However, the number of hours right now does not include administration of Narcan. Therefore...if it was allowed, more training would need to be done!! WOW...more education! :shock: That means more hours of training. :roll: I just found out that a service that neigbors my city allows EMT-i's to administer Narcan with their protocols. This is because the med.director held a training class to 'EDUCATE' the Intermediates. And with all the problems that Paramedics are having in the news these days...what gives them the right to talk about how EMT-Is actions? How many of you paramedics have given 'paramedic drugs' for an unconcious unresponsive and get to the ER and find out later that a d-stick was 20? i hear about it quite often from ER docs all over. Paramedics treating the monitor, or not utilizing a basic skill...using the glucometer. So now I ask...after proper additional training by a medical director, what is wrong with Intermediates administering Narcan? Link to comment Share on other sites More sharing options...
Nate Posted May 2, 2006 Share Posted May 2, 2006 And with all the problems that Paramedics are having in the news these days...what gives them the right to talk about how EMT-Is actions? How many of you paramedics have given 'paramedic drugs' for an unconcious unresponsive and get to the ER and find out later that a d-stick was 20? i hear about it quite often from ER docs all over. Paramedics treating the monitor, or not utilizing a basic skill...using the glucometer. I've never had that problem, checking the BGL is right there in the list of vitals that we take after we make sure the person is alive. So now I ask...after proper additional training by a medical director, what is wrong with Intermediates administering Narcan? The fact that they still can't fix any other issues that might arise with the adminstering of Narcan. Link to comment Share on other sites More sharing options...
Dustdevil Posted May 2, 2006 Share Posted May 2, 2006 So now I ask...after proper additional training by a medical director, what is wrong with Intermediates administering Narcan? If you really have to ask that question, you are hopelessly clueless and incapable of understanding. Which is, in itself, an answer to your question. Link to comment Share on other sites More sharing options...
PRPGfirerescuetech Posted May 2, 2006 Share Posted May 2, 2006 If you really have to ask that question, you are hopelessly clueless and incapable of understanding. Which is, in itself, an answer to your question. Im with you to a point on this, but a slightly different spin. Traditional training in EMS is, at this time at least, a monkey see monkey do course, regardless of level. This allows for a narrow viewed mantality, and discourages thinking outside the box. EMS doesnt teach medicine, just technical level monkey see monkey do BS. When EMS providers are taught, or self learn actual 'medicine', they will be able to see the bigger picture, and fully comprehend why this thread shouldnt have gone past one page of responses. His issue, isnt lack of competence, its that his education hasnt brought him to a point of being able to see the bigger picture. When EMS providers are actually taught medicine, as medical practioners, I will give you the personal PRPG guarantee that this discussion wouldnt even come up. XoXo PRPG Link to comment Share on other sites More sharing options...
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