Interesting call, seeking feedback.

[EMSLuke134]

I run with a BLS service. we were dispatched to a drunk. we found a 30ish y/o male seated on a stoop, slumped over. pt unresponsive initially, but with some rousing, was found to be alert to pain. pt had no signs of trauma, and had a beer can in his hand, unopened. so we get he on the stretcher, and he wasnt breathing so hot. Get him in the truck, get a nasal airway in. partner starts to get vitals. i realize this guy is breathing slow, and shallow. I decide to assist ventilations with bvm. guy is tachycardiac with pinpoint pupils, to me sounds like an opiate od. heres the weird part,. we get to the ER, and upon the nurses assesment, the pt is breathing adequately, and indeed he was doing fine now on an nrb, still unconcious.the question is this, what could possibly cause such an improvement so rapidly? did we stimulate his depressed respiratory system? or was i just being overcautious with the bvm? obviously, i`d rather be not sure and assist ventilations than not bag someone who needs it, but he was definitely shallow and slow, and definetly improved in the ER. now, i left on another job, and didnt see if they hit him up with narcan or not. any input is welcome.

Lucas Simko-Bednarski

NREMT-B/NJ EMT-B

[Rezq304]

You can't hurt the guy by bagging him. If all else fails, err on the side of caution.

[Dustdevil]

Mind you, I am not saying that is what happened with your patient, as I simply do not have sufficient information to say that. However, it is certainly possible that you stimulated spontaneous respirations (although, that sounds like an oxymoronic concept) with your bagging. I suspect that the same basic mechanism that allows us to manually stimulate respirations in the newborn continues to exist throughout the lifetime, and occasionally comes in quite handy.

There are other possibilities though. Regardless, I think you acted entirely appropriately. Good job.

[Medic_student_Jimbo]

Once had a guy who took some oxycontin and 3 traveler flasks of Jim Beam. Pupils pinpoint, breathing 2 times/min, cyanotic/pale/and diaphoretic. Had one of my partners insert an OPA and begin bagging. My other partner got an IV Going. We moved the pt just so slightly so my partner bagging the pt could be more effective, and as we moved him, the guy woke up. it scared the crap out of all of us, and he was CA&OX3 all the way to the hospital. Basically, as I was told by a nurse at the hospital, when you combine ETOH and some narcotics, it just intensify's the effects, and when the pt's brain becomes hypoxic they then go unconscious. When you change that, the brain begins to work slightly better again, possibly even regaining consciousness. So this story sounds very familiar

[scratrat]

I run with a BLS service. we were dispatched to a drunk. we found a 30ish y/o male seated on a stoop, slumped over. pt unresponsive initially, but with some rousing, was found to be alert to pain. pt had no signs of trauma, and had a beer can in his hand, unopened. so we get he on the stretcher, and he wasnt breathing so hot. Get him in the truck, get a nasal airway in. partner starts to get vitals. i realize this guy is breathing slow, and shallow. I decide to assist ventilations with bvm. guy is tachycardiac with pinpoint pupils, to me sounds like an opiate od. heres the weird part,. we get to the ER, and upon the nurses assesment, the pt is breathing adequately, and indeed he was doing fine now on an nrb, still unconcious.the question is this, what could possibly cause such an improvement so rapidly? did we stimulate his depressed respiratory system? or was i just being overcautious with the bvm? obviously, i`d rather be not sure and assist ventilations than not bag someone who needs it, but he was definitely shallow and slow, and definetly improved in the ER. now, i left on another job, and didnt see if they hit him up with narcan or not. any input is welcome.

Lucas Simko-Bednarski

NREMT-B/NJ EMT-B

Where did you find that old patch??? They're still around???

[xselerate]

kinda funny but i had almost the same job... only we found the guy with the top of his head on the ground and his body stooped over as if he had been walking, put his chin to his chest and fell straight down onto the top of his head. we gave each other the bullsomthin look and walk over to this guy at which point we tell him to get up and offer a small nudge to his leg. when he didn't move i supported his neck and we turned him around and supine onto the ground. he was cyanotic to his entire face with severely poor capillary refill to his chest... i know that sounds weird but i don't know how else to describe it. if i pushed down on his chest softly with my hand it left a pale area the shape of my hand that took approx 6 secs to return to color. oh... and he reeked of alcohol.

we immediately called for als back, immobilized for the odd position we found, striped him to check for unknown injuries/illnesses and began ventilating. medics showed up and continued ventilating for a few minutes before his resps became more normal and we switched to a nrb. he was able to answer yes and no questions by the time we got to the er...

still can't figure out what the hell was going on with him...

[mobey]

What did you do with the unopened beer??

Sounds like you did the right thing, I had a simmilar call. The guy was Cx on arrival but as soon as he hit my stretcher he quit breathing. We bagged him all the way to the hospital where he awoke and abruptly jumped off my cot and climbed onto the hospital bed under his own power. A few minutes later he passed out again and quit breathing a second time. The doc shot him with Narcan, but it made no difference, so we brought in the guys girlfriend to keep him awake so he would keep breathing...Worked like a charm.

CNS depressant indeed. :shock:

[EMSLuke134]

we had a party with it and other drinks from other patients. we even did some crack we took off a crackhead....lol actually i think we just left it on scene.

[AnthonyM83]

The guy was Cx on arrival

I'm not familiar with this abbreviation...at least not in this context.

[mobey]

I'm not familiar with this abbreviation...at least not in this context.

Conscious... I may have made that one up :-k