re: Question about fentanol?

quote:

---

You have no idea what you are taking about. Narcan is only administered when someone is overdosing, so who gives a shite about the patients feelings when they are turning blue

---

I'm an ER pharmacist and have responded to more ODs than you have years alive on this planet.

quote:

---

more white, sometimes almost grey


Heroin is more Brown almost like brown sugar (in Nola atleast)

---

bruh... you ain't back in them streets, huh?

It can, but no where near as pronounced.

You have endogenous transmitters in your body that bind to those receptors and narcan can reverse all of them. But it shouldn't make them go crazy like giving narcan to someone who had one too many doses of Dilaudid.

Yeah, sorry about the spelling, don't use spellcheck or autocorrect. Carry on, please?

quote:

---

Not even slightly... just trying to drop some info

---

phew!!!

good deal, how you been?

quote:

---

I'm not too up to speed on their training needed to do this, but I will tell you ACLS training won't give them the clinical acumen necessary to make the judgement call. I remember a patient brought into my ER and I responded to the intubation code- heroin OD. Paramedics gave him narcan in the field and had to re-sedate him after because he started fighting them. Doc was pissed. He asked how he was satting and if he ever lost a pulse. They said his 02 SATs were 88-95 but his respiratory rate was like 4-6. He yelled at them for like 5 minutes asking why they narcan'd a reasonably stable patient

---

I agree with everything you just said. ACLS certified is not nearly enough training. It is funny how some people think they will just walk up to a blue person and give him some Narcan and all is well. There is a lot more to it than giving Narcan such as airway management, hemodynamic management, cardiac, trauma, injuries etc.... A police officer is just not qualified or trained to be able to handle an emergency medical situation when seconds matter and multiple tasks need to be completed immediately and I don't think there is a single police officer that wants that liability either. Paramedics are very good at their job because that is what they do for a living.

Yes, exactly. And in my previous example, paramedics gave it despite the patient having decent O2 SATs. He wasn't dying. He was just very, very sleepy.

"First do no harm". So they gave him narcan and he's not in respiratory depression, great.

Oops, now he's mad and combative and in some sort of psychotic delirium (you don't know if he only took an opiate- he could be on a psychotropic too like this guy was and now he's delirious and mad). Now we have to give him versed or propofol which have their own array of problems.



Or we could just not have given narcan and monitored his o2 SATs while en route to the ER.

It's not just about the patients feelings- it's about the complete picture and understanding how one thing you do now could have an effect on what happens down the line. Risk/benefit

You taught me a lot tonight

A highly publicized case from a few months ago where an officer had to be routed by EMS after brushing it off of a uniform.

LINK

When I was diagnosed the second time with Stage Lymphoma, I had a 16cm tall by 9cm wide tumor wrapped around the lumbar region of my spine. I was in so much pain that 3 OxyContins a day could barely relieve the pain. It was real bad. They prescribed me Fentanyl and it had some adverse affects on me. The pain was less but I was flush like I had taken 5 Viagra and I was constantly dizzy. I had double vision within 30 minutes of putting the patch on and had to put an eye patch over my left eye to see straight. Within 24 hours my left eye drooped like I had had a stroke. Luckily, I was scheduled to begin treatment a few days later and I just quit that after a day and suffered through the pain. That drug had me so disoriented that I just chose to suffer through with OxyContin.

It is WAY stronger than oxycontin and I don't blame anyone for not wanting to handle one of those patches without a barrier.