Letters: Giving training and oversight to administer naxalone

Providing good oxygenation and airway management remains the first step.

Editor, The News:

Re: ‘Dead’ wrong on naloxone (Letters, Feb. 3)

Mr. Hames correctly points out that administering naloxone under the recently announced BCEHS first responders program is no substitute for ventilating a drug overdose patient who has stopped breathing.

Providing good oxygenation and airway management when a first responder arrives remains the first step in responding to any overdose emergency under our new initiative.

However, a patient may be difficult to ventilate for physiological and/or anatomical reasons.

A patient may lose his or her airway reflexes, or BVM (bag valve mask) ventilation may push air into the stomach, increasing the risk of aspiration in both cases.

Naloxone can quickly reverse the respiratory depression caused by an opioid overdose.

Our training reinforces the importance of good airway management and oxygenation, and the treatment protocol specifically directs first responders and paramedics to ventilate the patient first, before considering the administration of naloxone.

Further, first responders will be trained to administer naloxone only when confirmation of clinical appropriateness of naloxone deployment is provided by one of our 32 emergency physicians available 24/7 under our Emergency Physician Online Support (EPOS) program.

Last year in B.C., 465 people died of a drug overdose, and the number of overdoses has been increasing at an alarming rate over the past few years.

The aim of our new initiative is to save lives and give first responders, as well as paramedics the necessary training and oversight to safely administer naloxone.

William F. Dick,

MD, MSc, FRCPC

Vice-President,

Medical Programs

B.C. Emergency Health Services

 

‘A piece of themselves’

Editor, The News:

Re: ‘She died in from of me’ (The News, Jan. 29).

Colleen Flanagan, your article offends me deeply. I am a paramedic and have had to respond to many overdoses in my career. I have also been unsuccessful in reviving people who have suffered a cardiac arrest due to an overdose.

This experience is traumatic for all parties involved. There has not ever been a cardiac arrest that hasn’t affected my heart. The death of a patient is extremely hard on emergency responders, but professionalism holds us from showing that emotion publicly.

All this said, your article was written without due care for clarifying facts. Starting from top of your article, CPR should never be initiated on a person who still has a pulse as it can cause much more harm than good.

The fire department arrived with in two minutes, not 10, and even though at this time they cannot administer Narcan, they have other very effective skills to assist in an overdose. Narcan will not reverse a cardiac arrest. It will only help in an opioid overdose, and with thousands of chemical compounds a person could consume to cause an overdose, it’s not a guarantee.

When a person is found alone in cardiac arrest, with no information, paramedics have very little to go on as to the reason of the cardiac arrest, overdose is only one of dozens of options for the cause of the arrest.

When the paramedics arrived seven minutes after the call, not 30 as your subject leads the reader to believe, I assure you they did much much more than “pump on her chest.” They would have preformed dozens of tests and procedures to not only treat the cardiac arrest, but to also find the initial cause of said arrest, and I can assure you they would never give 30 shots of Narcan. Also, best treatment is to stay on scene and do everything possible to get pulses back before moving the patient.

Your article is extremely disrespectful to the men and women who give a part of their heart to attend to people they don’t know in situations they didn’t create, but take all the blame when even their best isn’t enough.

I hope you reflect on how poorly you covered this story, write an apology to the paramedics and firefighters who gave a piece of themselves to try to save lives and do a much better job of writing in the future.

Sara Schubert

 

Falling on deaf ears

Editor, The News:

Re: Ambulance reforms pledged to shrink waits (mapleridgenews.com).

I was  so disappointed when I learned that Maple Ridge and Pitt Meadows were not the new location for one of the eight new B.C. ambulances.

I guess all the information provided to  our  MLAs Doug Bing and Marc Dalton fell on deaf ears. It seems to that other MLAs, in  Surrey-Langley, Abbotsford, North Vancouver, get the job done and we’re left short of emergency services.

This is a serious matter that needs to be addressed immediately.

Robert Mckee

Pitt Meadows