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


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

63 members have voted

  1. 1.

    • yes
      30
    • no, it's should be a paramedic drug only
      31
    • undecided
      2


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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.

Long term withdrawal is not life threatening, but acute withdrawal secondary to a high dose of Narcan is. You are instantly throwing someone into withdrawal, the body reacts violently. Look at the list, I consider arrythmias/tachycardias and seizures life threatening. This is why I believe it should be a Paramedic based intervention only.

Peace,

Marty

:thumbleft:

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The whole proposition is stupid! It's a slippery slope argument.

  • "I want Narcan just in case."

"Narcan causes seizures? Well then I want Valium, just in case!"

"Valium causes apnea? Well then I want Romazicon, just in case!

"Romazicon causes arrhythmias? Well then I want ACLS drugs just in case!"

  • want is more education. :roll:
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The whole proposition is stupid! It's a slippery slope argument.
  • "I want Narcan just in case."

"Narcan causes seizures? Well then I want Valium, just in case!"

"Valium causes apnea? Well then I want Romazicon, just in case!

"Romazicon causes arrhythmias? Well then I want ACLS drugs just in case!"

You are the man. Well put, Dust....once again.

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Apparently the only thing the skills-poachers don't want is more education. :roll:

Maybe we should start by getting rid of all those skills-poaching paramedics who aren't licensed. We could reduce the number of medics on trucks by actually requiring them to be more educated.

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Maybe we should start by getting rid of all those skills-poaching paramedics who aren't licensed. We could reduce the number of medics on trucks by actually requiring them to be more educated.

I'm all for that.

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Dust:

Apparently the only thing the skills-poachers don't want is more education.

that just goes to show your ignorance. you seem to ASSume that because Intermediates would like to have the availablility of a drug other than O2, that they don't want more education. I see this as highly incorrect. If you will look to another section of this site, you will see a topic about paramedic students uniting...in this thread there are people (some probably intermediates already) beginning their paramedic class. :roll: that seems to be 'more education'.

And if you think that you are a supreme being because you think that way...oh well good thing you retired (or so you signature says).

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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.

All well and good , if you happen to have a paramedic within earshot. Many places DO NOT have one available within the travel time to the hospital. Yeah I know you have five minute travel time to multiple ER's. A lot of us have travel times over an hour in nice weather, and on a good day we might be able to intercept with a medic somewhere along the way ,OR not!

In a perfect world every small town would have an ambulance on every street corner , staffed with two advanced care paramedics and a thoracic surgical team just in case they were needed , then the paramedics could sit up front & hold the steering wheel. OOPS i must have gotten into D D's meds.

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You're being awful selective in your reading, fireman. I suppose you have conveniently overlooked the glut of topics here by EMT's that are either looking for the FASTEST way to become a paramedic, or whining about how many more skills they should have WITHOUT paramedic school, just like this very topic. Buy a clue.

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Not every ambulance requires a Paramedic. Silly assumption. And Intercepting ALS is most definitely your best bet. Even if it does take 20 minutes, there's still much airway management involved which I'm certain everyone is familiar with. Isn't that what the patient needs the most?

Good BLS followed by Good ALS, not a mix-match of limited ALS skills.

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dust:

You're being awful selective in your reading, fireman. I suppose you have conveniently overlooked the glut of topics here by EMT's that are either looking for the FASTEST way to become a paramedic, or whining about how many more skills they should have WITHOUT paramedic school, just like this very topic. Buy a clue.

:roll: if i could only buy a clue as to why you read too far into a thread... I am not concerned with the seeking out the 'fastest way' to paramedic, or the whining of how many more skills without paramedic school. My question was a question of if intermediates should be able to use it. there are a lot of services that do...and a lot that do not. This was not a 'why can't i push more drugs and not go to paramedic school' thread, though you seem to read it that way.

I am all for higher education. I am also in agreement that basics and intermediates don't have enough education yet to push most drugs, OR understand the effects behind it. However...under proper medical control, or paramedic authority, why shouldn't intermediates be allowed to push things. It takes 1 task off of the paramedic so he/she can begin the next task needed.

i'm sure there are times when paramedics would let an intermediate do something above their scope, but LEGALLY they cannot. This is one of those items. i've been witness to this exact situation. A medic has told an intermediate that he can push it, but he refused because he didn't want to lose his patch. So then the medic had to stop what he was doing, and administer the narcan, then go back to his other duties of patient care. Now, before you read too far into this :roll: , yes he could have done all of it by himself (which he did), but it could have been a bit quicker had help been available.

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