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Noloxone...should EMT-I's be able to administer?


Should EMT-I's be able to administer Narcan?  

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    • yes
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    • no, it's should be a paramedic drug only
      31
    • undecided
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I am in favor of EMT-I's being able to administer limited medications as long as they have completed the EMT-I certification process along with a pharmacology class and exam and are authorized by their EMS agency, Medical Command, Medical Director and State Office of EMS to do so.

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Nobody has really given a valid reason as to why the EMT-I would need to give Narcan (or most other meds for that matter). Why is that? Is it maybe because there really is no valid reasoning for it? That's my guess...

Shane

NREMT-P

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Nobody has really given a valid reason as to why the EMT-I would need to give Narcan (or most other meds for that matter).

"Valid" is the key term here.

I always hear a lot of "because we can" and "because we should" and "because I want to." But yeah, valid justifications are definitely in short supply. In fact, I think they are a mythical animal like the unicorn.

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Here are some of the side effects of Naloxone....

Nausea

Vomiting

Diaphorisis

Tremors

Dyspnea

Seizures

Arrhythmia's/tachycardia's

Peace,

Marty

:thumbleft:

Please correct me if I am wrong ( a rare, but nevertheless possible occurence) but the S & S you listed above are not actually side effects of Narcan but symptoms of opiate withdrawal. An unpleasant but not life threatening condition.

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Hammer, looks like your correct on this one. I would personally rather deal with some effects of opiate withdrawal if my patient actually had a chance at breathing on his own.

Naloxone (Narcan)

Class: Narcotic antagonist.

Actions: Reverses effects of narcotics.

Indications:

Narcotic overdoses including the following: Codeine, Demerol, Dilaudid, Fentanyl, Heroin, Lortabs, Methadone, Morphine, Paregoric, Percodan, Tylox, Vicodin, synthetic analgesics,

Overdoses including the following: Darvon, Nubain, Stadol, Talwin, alcoholic coma,

To rule out narcotics in coma of unknown origin.

Contraindications: Patients with a history of hypersensitivity to the drug.

Precautions: Should be administered with caution to patients dependent on narcotics as it may cause withdrawal effects. Short-acting, should be augmented every 5 minutes.

Side Effects: none.

Dosage: 1-2 mg.

Routes: IV, IM.

ET (ET dose is 2.0-2.5 times IV dose).

Pediatric Dosage: < 5 years old > 5 years old 0.1 mg/kg 2.0 mg.

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Hammer, looks like your correct on this one. I would personally rather deal with some effects of opiate withdrawal if my patient actually had a chance at breathing on his own.

Society would rather you simply call for those who are properly educated to do so rather than overstepping your scope of education.

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Please correct me if I am wrong ( a rare, but nevertheless possible occurence) but the S & S you listed above are not actually side effects of Narcan but symptoms of opiate withdrawal. An unpleasant but not life threatening condition.

They are both, they are the side effects of opiate withdrawal which you can induce by administering Narcan. Remember the mechanism of action for Narcan, it blocks the receptor sites for opiates, thereby creating withdrawal like symptoms. If you push too much Narcan you can put the patient into a very fast pseudo withdrawal, and yes that can be life threatening.

Peace,

Marty

:thumbleft:

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Society would rather you simply call for those who are properly educated to do so rather than overstepping your scope of education.

Well I'm glad that "society" trusts your opinion so much it would let you speak on its behalf.

If it's authorized by medical control then it should be allowed. This is not something new, there are states that allow EMT-I's to push narcan. I think it's a good idea, especially for services who don't have a paramedic for every truck.

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They are both, they are the side effects of opiate withdrawal which you can induce by administering Narcan. Remember the mechanism of action for Narcan, it blocks the receptor sites for opiates, thereby creating withdrawal like symptoms. If you push too much Narcan you can put the patient into a very fast pseudo withdrawal, and yes that can be life threatening.

Peace,

Marty

:thumbleft:

Nope. Sorry your wrong.

On the first point i will concede that it could be considered an issue of semantics. However, opiod withdrawal is not life threatening. alcohol yes, Barbs yes, heroin no.

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If it's authorized by medical control then it should be allowed. This is not something new, there are states that allow EMT-I's to push narcan. I think it's a good idea, especially for services who don't have a paramedic for every truck.

In other words, just more of the "because I can" school of medicine instead of because we should.

Good thing for you that paramedics are simply certified instead of licensed. In that case, this would all be a moot point and all these undereducated, shortcut skills poachers would be rounded up and run out of town with a big rip in their sleeves where their patch used to be.

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