Narcan do…!!!

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I recently attended a call to a ‘male unconscious, life status questionable?’  The location was close to the centre of Big City alongside a public footpath. On arriving scene we were shown to where two Police officers were standing near to some bushes. ‘He’s in there!‘ One of the officers pointed to the nearest large bush which hid from public view a ‘smackheads den’.

We carefully climbed through the bushes trying to avoid the discarded syringes that were lying around everywhere until we found our call. The male was on his back, eyes closed, skin looking a very pale colour with just a hint of dusky blue starting to appear around the mouth. It was easy to see that his resps were down…really down! He was breathing at about 4 times a minute (normal rate should be 16 – 20 for a young adult at rest).

His pupils were more pinpoint than a big bag of pin pointy things on national pin point day! It was safe to assume that he had ‘gone over’ or had o/d on heroin. I grabbed hold of his shoulders and give him a good ‘ragging’ which elicited a slight response. One of the amazing things about reversing a heroin overdose is the simplicity of certain techniques. We sometimes attend addicts who have overdosed and are soaking wet through their friends dumping them in the bath or shower.

Grabbing an overdose by the shoulders and pulling them upright throws the head back quite forcefully (obviously we would not do this if trauma was suspected). This has an effect on the baroceptors and nerves within the neck and sends a message to the respiratory centre in the brain to kick in again. This sometimes does not work and we go to plan B. Of which all will become clear.

Our patient managed to struggle to his feet with our help. As he did so I could see the needles he had been lying on and other debris such as the plastic shopping bags that had once held stolen items used to pay for their hit. Various empty cans of extra strength lager lay about. This was about four feet from the public footpath were kids played up and down on their bikes. Our patient was still under the influence but breathing properly although he kept drifting off.  

We were approximately a hundred metres from our truck. ‘Come on then matey, sit on our little chair…’  Our patient sat down on the floor instead, his head dropped onto his chest and his arms hung by his side. This is a common response to heroin overdose and usually does not present much of a problem…usually. Sometimes they can go back over and go into respiratory arrest. If we are there then we can sort it out. If they are on their own…there is every chance that they will have a very long sleep…forever!

‘Right, I’m off back to the truck to get the NARCAN’  (Powerful opioid antagonist that reverses overdoses and respiratory depression if administered at the right time). As soon as I had finished saying the sentence our patient sparked up and was on his feet like a shot. ‘NARCAN…no way! I don’t  want no NARCAN!’  Through half closed eyes and on unsteady feet he made his way off down the footpath. He made it about ten feet away when he stopped, dropped his head and started to buckle at the knees.

‘Look fella! I’ll give you a loading shot of NARCAN and then we can decide what to do with you!’ I said to him as I shook him awake again. ‘NARCAN…don’t want that stuff…do you know how much I paid for my hit?’And with that he was off again on his travels. For another ten feet. He stopped again…started to buckle at the knees again.  Turning to my crew mate I mention again about going back to the truck and getting the NARCAN. ‘No way I said…I’m off…don’t want NARCAN!’  Off he went again staggering down the footpath…for another ten feet!

This time I just say the word out loud ‘NARCAN’ It has the desired effect, he re-sparks up and walks away. Every ten feet or so he stops…and I shout out ‘NARCAN!’  This goes on for almost a hundred metres until he disappears around the corner. I have never known NARCAN to be so effective before, without even having to give it! I wish all our meds were that effective!  No doubt our paths will cross again and maybe we wont be able to help next time. (We double checked before leaving scene that he had not collapsed around the corner-a ‘friend’ came and took care of him.)   

walk

14 Responses to Narcan do…!!!

  1. piratedani says:

    it made me laugh again!!!
    I knew NARCAN was good, but not that good. Its a shame you cant train all your patients to react in the same way

  2. Stuart says:

    I want to know what you wrote up for paperwork
    “Administered Narcan via shouting. Had desired affect, patient walked off.”

  3. kingmagic says:

    Unfortunately on our PRFs all we have are tick boxes for IV, sublingual, IM, SC and oral. We should have one for ‘audio’ though!

  4. Vetnurse says:

    Well it was oral of a fashion you shouted he responded hence given oraly. :-D

  5. Rach says:

    Still a waste of your valuable time, wouldn’t it be so great to just be able to leave them??..xx

  6. Louise says:

    Ha!! Genius! I’ll try that one next time!!

  7. Is laryngitis in the Narcan provider contraindicated?
    Some how this post is all the more vivid, now I have a picture of KM my minds eye!!

  8. Bendy Girl says:

    LOL! Is there a change in the frequency of these kind of calls? In my local area the results of the no tolerance policy on drugs has meant lots and lots of raids on cannabis farms making that much more difficult and expensive to get hold of. So people have moved onto harder drugs. It’s more easy to obtain heroin than cannabis round here now. Watching friends descend into heroin addiction is awful, particularly because it’s an experienced staff nurse and a pharmacist who both knew the consequences of taking that junk and carried on anyway.
    Stay safe Big bro, lil sis x

  9. kingmagic says:

    Dani…I was thinking of incorporating ‘Pavlovs response’ into our guidelines.

    Vetnurse…his sense of hearing was very acute which I found strange given that he had taken smack. I think he had taken something else but he did not want to co-operate.

    Rach…I know what you mean Rach but he was someones son, brother maybe father. And he had tried to keep it private but was found by someone else. Gave me job for the old memmoires though. x

    Louise…not guaranteed to work but give it a go.

    UHDD…a bit of a difference in location from a smack den behind some bushes to the beautiful location where you live.

    Lil sis…we are having more finds of industrial sized cannabis farms (whole houses taken up from floor to floor, wall to wall). Heroin seems to the same amount of users and calls. But we are getting more calls to cocaine related incidents and it seems that crack is on the rise. x

  10. Hi could you add PoliceOne.com to your Police Links?

  11. Noddy says:

    I wonder just how the sudden death stats would look like but for the wonders of Narcan. Sometimes I wonder, as you hint at, if we are just delaying the inevitable and hiding the true costs in lives ‘lost’ of this pernicious addiction by administering Narcan. It’s a catch 22 situation.

  12. kingmagic says:

    Noddy…Narcan has helped save so many lives that people dont know about. Some of those saved have gone on to beat their addiction and lead healthy lives…some have continued with drugs and ultimately paid with their lives.

    I’m not sure if stats have been done for Narcan use. It would make interesting reading though.

  13. Richard says:

    Great conversation and a definite good read. I have a question which seems to bear no easy answer, much less one at all:

    Has anyone ever heard of Narcan being used for a ‘cannabis overdose’. I know, I know, but please, no cannabis experts chime in here.

    I worked for a surgical staffing company that I owned for fifteen years before being shot in the chest when I stopped for some gas one night, on the way home from a long stint I had just finished working at, as a first assistant at a hospital I staffed PRN. The bullet was not through-and-through. Instead, the shell (and what are 32. caliber shells made from, metalwise?) lodged itself directly under my left sub-clavicle between my lung & heart (my full story at Colorado-CHRONIX com). Causes chronic pain secondary to the RSD (reflex sympathetic dystrophy) or complex regional pain syndrome, as it’s referred to now.

    In any event, and back on topic, is there anyone here who’s heard of ‘cannabis overdoses’ being treated with anything but the regular dia-loraze-clona-zepam cocktail? Is Narcan indicated at all by any source, anywhere to anyone’s knowledge?

    Much appreciation…

    Warmly;

    -DOC
    Colorado-CHRONIX com

  14. Cocaine Monster says:

    Where’s my miracle??
    Jesus turned water into wine. I want a miracle too.
    Perhaps the modern prophet should get a modern miracle::Turn sugar into cocaine. I’d hear from my sister then. “We’re having a party. Come on down. All my friends will be there.” Yea, I bet. Will your serial killer boyfriend?
    We both know she hooked up with him. They both ran in the same type of circles, and having a party at the house was a green light to all the trash to come get some. Good punishment too. Wouldn’t be surprised if her IV drug abuser friend had sex with Loren?
    In addition in her case she was the butt of jokes:::She reached the point of blackout so frequently people enjoyed having fun with her in her condition. Those who joked with her expense learned a prank with Cheech and Chong’s Ajax scene.
    “Where’s my mommy?” “She’s shooting up in the other room.” “Again?”:::How many weekend nights did they spend injecting drugs while their children slept in the room next door??
    How often do they enjoy a quick “toot” before going into the office? The fallacy here is the possibility of “extra” from the weekend.
    Have either been administered narcan? Also do they keep doses onhand in case of “accidents”.

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