Ga-Lin

As others have mentioned, if you give the recommended dose, you run the risk of waking the patient up and they can get very violent (A number of inexperienced medics have been assaulted. I had a very large & very angry individual grab our drug box and fling it down the stair well of a 4 story walk up, nothing was salvageable).
Possible side effects include: change in mood, increased sweating, nausea, nervousness, restlessness, trembling, vomiting, allergic reactions such as rash or swelling, dizziness, fainting, fast or irregular pulse, flushing, headache, heart rhythm changes, seizures, sudden chest pain, and pulmonary edema. But you also run the risk of projectile vomiting. Never knew a patient laying on the stretcher could hit the ambulance ceiling like he was a fountain.
If you do wake the patient, they will want to RMA, the problem is the half-life of narcan is shorter than the half life of opiates. So the narcan wears off before the opiate and if they have enough on board they will go back into respiratory depression/arrest after the RMA.

There are no ill effects, that I know of, if given to someone who is not experencing an opiate overdose. The only bad effects would be giving Narcan to an opiate OD (morphine, heroin, methadone, codine and the recently popular synthetics vicaden, hyrdocodone) to quickly, which may cause sudden and violent withdrawal, in addition, if you administer enough to actually wake them up you will also have to deal with an upset junkie for "ruining" their high. Sometimes this can get out of hand. The other problem with waking them up is they always want to RMA which means forcing them to go or leaving them. This usually means you WILL be back for them (if they are lucky OR they get to go to that big shooting gallery in the sky) ALS usually gives just enough to get people to start breathing again on their own. I'm not sure of the uptake or dosage of the IN narcan. Opiate OD's are actually pretty easy to care for, you just have to breath for them. The last few years I've been telling students that if they are working in an tiered system and they have a complicated route back to the ambulance (flights of stairs mostly) to call for als backup (if they aren't on their way already), and stay put, cause it's not possible to bag someone going down the stairs and you always think you can get a "little" farther between breaths.

Those violent reactions usually occur when the drug is given too fast via the IV route. I haven't seen it happen when given IN.
Like ALL drugs, narcan must be given carefully, with good judgement and when indicated.
I think we're forgetting an important fact though. The issue is respiratory depression. This is easily managed by any BLS trained provider. You don't need a magic drug to fix it. You need a BVM.

Having been assaulted and witnessing other responders being assaulted (after 1 individual was "agitated" he attacked ER staff member causing serious head trauma, then he pulled a knife on security. it took 6 responders to restrain him including 1 ESU officer, who almost lost his gun during the fight). Since that was about 25 years ago and I'm still in it, I am not worried as I KNOW how to titrate (adjust) the dose to bring back respirations, but keep them mellow enough that no one is put in danger. My concern is this is not being taught to all these minimally trained responders.
And a BVM will keep them alive. I would rather see that in every PD car before narcan. Since it could help many people, while narcan only helps a small % of that.

There are no ill effects, that I know of, if given to someone who is not experencing an opiate overdose. The only bad effects would be giving Narcan to an opiate OD (morphine, heroin, methadone, codine and the recently popular synthetics vicaden, hyrdocodone) to quickly, which may cause sudden and violent withdrawal, in addition, if you administer enough to actually wake them up you will also have to deal with an upset junkie for "ruining" their high. Sometimes this can get out of hand. The other problem with waking them up is they always want to RMA which means forcing them to go or leaving them. This usually means you WILL be back for them (if they are lucky OR they get to go to that big shooting gallery in the sky) ALS usually gives just enough to get people to start breathing again on their own. I'm not sure of the uptake or dosage of the IN narcan. Opiate OD's are actually pretty easy to care for, you just have to breath for them. The last few years I've been telling students that if they are working in an tiered system and they have a complicated route back to the ambulance (flights of stairs mostly) to call for als backup (if they aren't on their way already), and stay put, cause it's not possible to bag someone going down the stairs and you always think you can get a "little" farther between breaths.

There are no ill effects, that I know of, if given to someone who is not experencing an opiate overdose. The only bad effects would be giving Narcan to an opiate OD (morphine, heroin, methadone, codine and the recently popular synthetics vicaden, hyrdocodone) to quickly, which may cause sudden and violent withdrawal, in addition, if you administer enough to actually wake them up you will also have to deal with an upset junkie for "ruining" their high. Sometimes this can get out of hand. The other problem with waking them up is they always want to RMA which means forcing them to go or leaving them. This usually means you WILL be back for them (if they are lucky OR they get to go to that big shooting gallery in the sky) ALS usually gives just enough to get people to start breathing again on their own. I'm not sure of the uptake or dosage of the IN narcan. Opiate OD's are actually pretty easy to care for, you just have to breath for them. The last few years I've been telling students that if they are working in an tiered system and they have a complicated route back to the ambulance (flights of stairs mostly) to call for als backup (if they aren't on their way already), and stay put, cause it's not possible to bag someone going down the stairs and you always think you can get a "little" farther between breaths.

I think this guy should be given a fair trial, judged by a jury of his peers (us), followed by a first class hanging!

How great is it that, with the exception of some everyday ailments that come along with fighting fires, no one was injured. The possible leadership issues, possible empty tanker, possible malfunctioning smoke detection system are all insignificant at this point. I hope each member of the GBFD had a nice meal with family tonight, lets Monday morning quarterback and solve all of the World's problems and GBFD's potential problems another day.

I'm not sure what the law is in my town but being an emergency responder, EMS not a FF, I know the importance of clearing the hydrant. Carrying shovels on the truck if fine but I know that time wasted may mean the difference in saving a home vs the foundation. After clearing a path out to my road that's the first thing I clear, then I go back and dig the cars out. Oh yeah, I guess I do have some added motivation....the hydrant is right in front of MY house!

In a few recent threads, members have questioned "why hasn't this been posted yet?".
In most cases, the member had knowledge of the incident and didn't post it. Why the complaint If you're going to ask what took so long on something to get posted, and you knew about it, then why didn't YOU post it?
Seth

You are right in many ways and I fully respect your views, but as one who has been on both sides of the drug abuse fence I can tell unequivocally that the legal repercussions of drug use are an insignificant deterrent if they are one at all. Now I'm sure some will blow a head gasket with this next comment but when it comes right down to it drug addiction is no different than alcoholism other than alcohol is legal and drugs aren't. The root causes of both afflictions are the same. And when we look at the effectiveness of prohibition it's clear that making alcohol illegal created far more problems than it solved, that's why they repealed the 18th Amendment (alcohol is also a drug by the way). Today people still abuse and illicitly produce and distribute alcohol, but by far making alcohol legal again and giving those who want to drink access to it legally has been the best road to take. And in this day and age with the societal views on drug use, prescription or otherwise, as they are and the stigma far less ingrained as it used to be, so is it with drugs too. No one likes to admit defeat, but the war on drugs, just like the one against alcohol in the 1920's, is one that is unwinnable and no amount of ire, disgust or contempt about drugs and drug users is going to change that.

I gotta agree with you Bill, Ya gotta get them when they are young. Starting in kinderkarten. I used to be a Boy scout Cubmaster and I would always find ways to work in the warnings of addiction, Tobacco, Alcohol, Drugs didn't matter. I would tell the old story about the Indian boy and the rattlesnake. We all, as a community, school, scouts, church/temple, home, where ever the kids are, need to constantly reinforce this theme that addiction is both bad & very easy. As our children get older you need to modify the approach. Teens really aren't affected by death, that is to say, they don't think much about it, however this age group are really fearful of disfigument. My own kids (at the time) came back from HS telling me about a presentation in their health class. The teacher gave a presentation telling them not to worry, not everyone is killed or dies from drunk driving. He then displayed a number of before and after pictures. A really pretty girl...Later scarred and severly disfigured (face) from an accident. A young man in his HS football uniform along with a caption on how he was just accepted to a top 10 school to play football on a scolarship.....Later on crutches with only on leg the caption here was "he just wanted one more for the road" you get the picture.
On the topic of those already addicted.... give it to them, make drugs legal. That is to say, if you register as an admitted addict in a national data base, you can just come in and get your needles, drugs etc. If they truly want help fine, otherwise.... Hell, I'd even change the rehab centers into state sponsored shooting galleries. I can gaurentee that within a few years new addiction #'s will decrease. Other benifits, decrease in crime rates and other quality of life crimes since addicts won't have to steal or pan handle in order to support their habit, related health issues due to impure drugs, sharing neddles and speading blood bourne pathogens & spesis due to dirty needles will decrease. Elimination of drug cartels and their related violence. The saving of BILLIONS of $ that we are hemmoraging in fighting this losing battle of trying to enforce drug laws. Goverenmental & law enforcement corruption gone. I gotta tell you that I truly believe that Colorado & Washington have the right idea. I read sometime ago that Portugal did this and this was their outcome.

Totally agree.Take a look at my post on this topic #10 on 1 Feb & #12 a few hours later.

“It's now very common to hear people say, 'I'm rather offended by that.' As if that gives them certain rights. It's actually nothing more... than a whine. 'I find that offensive.' It has no meaning; it has no purpose; it has no reason to be respected as a phrase. 'I am offended by that.' Well, so f****** what." - Stephen Fry

Yes and no. While securing the border would most likely cut some of the drug traffic across the border, it won't stop it, nothing defensive will. Even in places like Singapore and Saudi Arabia where drug possession and distribution means the death penalty there is still illegal drug use. In our case the money is just too enticing to think it would stop and truth be told there are alot of people whose livelihoods depend on the drug trade for a living..and I don't mean drug dealers, I mean DEA and State and local PDs as well. Please understand I mean no offense to law enforcement here, but by some accounts at least half of all crime is directly related to drug usage, so is it really in the best interests of those who fight that scourge and the crime it creates to see it gone completely? I think it's time to look at this realistically. Drugs have been here for centuries, they're here now and they are going to be here in the future and no matter how stringent the laws or how enlightened the education this is simply how it is. We have to grab this problem by the balls not the brains and hit them where it hurts, in the wallet. To pull the rug out from under the drug barons and their corrupt accomplices in law enforcement and politics the only real solution is legalization so that much of the profit and allure disappear. Do you think a junkie would buy street drugs if he could go to CVS and buy them legally for the same price or less? And by legalizing them they can be regulated in terms of purity and strength and taxed as well, plus most if not all law enforcement jobs would remain to ensure compliance to boot. And while even this would not eliminate illegal drugs completely, it would control them and their users far more effectively than the decades long "war on drugs" has done. And that's not an indictment of law enforcement either, they do the best they can under the circumstances when you realize that for every dollar spent to fight drugs at least two are spent to produce and smuggle them illegally and the drug lords still make billions...that's how much money we're talking about here.

We replaced heroin with pills which are now being replaced with, you guessed it, heroin.
In VT, the state:
-Allowed lay people to obtain and admin Narcan without a prescription
-EMT BLS Intranasal Narcan
-VT State Police pilot program, hopefully during the summer, that will put Narcan into every VSP patrol car for use by officers during overdose emergencies
We will never remove the human desire to "get high", what we can do is make the possibility of death as minimal as possible.

About 5 years ago when my oldest was in 6th grade, we (Somers FD EMS) did a thing, just one day, for just her class. We talked about a lot of stuff: FD and EMS as a career path, as a volunteer in the community, and drug abuse. This was so well received that it became a two day( one fire day, one EMS day), 4 times a year event (health classes change quarterly). While not focusing specifically on drug issues, we fit it in the message that there are two ways to spend a lot of time on an ambulance- as an EMT, or as a drug user. Not a big deal, but if we all worked a tiny bit on this, the end effect could be a positive change.

The kids need to know somehow the effects of heroin. As a retired correction officer of 25 years I have seen many addicts go throuring tygh some of the most horrific withdrawls....banging heads on walls, shaking, puking, scratching the paint off the walls, ramming their headhs into steel bars, crying, etc in a setting where no one really cares wether you live or die. They need to know heroin will either get you dead or locked up. Instead of trying to mess with the 2nd amendment or trying to ram this new common core program in the schools money needs to be spent on programs to deal with this. I also know a few kids that have died in the past from herion and the effect left on the families is horrible.

If you are a Critical Care Techncian in NYS (will Westchester be pushed into having them?) then the new protocols suit you well. Paramedics should take a hard, close look, compare them to the old protocols, and then come to a conclusion. You will be calling a doctor many, many, more times than you have in the past. ACLS? Dont bother...they dont follow the algorythms. They are great for the "I'm barely a medic" providers that live in the protocol book and cannot make an educated patient care decision on their own. Just my two cents.....

Contracting with an agency (volunteer, commercial, hospital, fire protection district, etc.) is not part of GML. What I believe you are referring to is a MUNICON, which is the municipalities ability to get a certificate of need (CON) without "approval" from the regional EMS council.
Their is no legal requirement in NYS for a municipality to provide EMS (however their are many legal requirements once they decide to). Their is also nothing in the law that prevents them from switching providers, unless they violate a clause in the contract with the existing service.
1st does CVAC hold the CON or is it the towns?
2nd this might open up a huge can of worms when it comes to mutual aid (what's in the plan?) and providing ALS?

From what little facts are available, I get from this that the VAC couldn't cover calls and contracted with a commercial company to provide 12 hour coverage during the day. According to the article, a village spokesperson said their liaison wasn't allowed to attend VAC meetings and there were issues to be resolved. The village of Chester exercised their legal right and canceled the agreement with CVAC and retained the services of MLSS. Since General Municipal Law says the municipality can provide ambulance service, it seems to me that they are within their purview.
Allegations of improprieties, golf games or gifts are purely hearsay. I can't believe the posts are even allowed to remain.
People may not like it and there may be sour grapes but as long as calls are being covered, isn't that the point?

I'm sure many more facts will be coming out as this grows legs in the media.

Emergency services are businesses and there is nothing wrong with following sound business and financial practices. In fact some of the best volunteer chiefs/officers run businesses as their full-time job bringing their expertise and experience to the VAC/VFD.

As a non resident I don't believe you have any standing to say anything. It's likly that you wouldn't even be permitted to attend a Town of Chester meeting. And pardon me for saying, but it sounds like you have a real hard *n for this MLSS and an unrelistic/unsupported/unsupportable belief in CVAC simply because they happen to be a VAC! Please! Remember Corona VAC in Queens. I say lets wait and see how this develops. Maybe the leadership really knows what they are doing and didn't banrupt the organization. Anything is possible.

And a corrupt &/or mismanaged volunteer system is sooo much better?

First of all, you are so wrong on so many aspects of this post that I don't even know where to start. How would you know the debt structure of a privately owned company? How do you know what their financial statements look like, and what they own vs. what they don't own? And if you are running an EMS service, shouldn't you try to have vehicles that are "nice and new" as opposed to old rust buckets that are unreliable? When did that become wrong and reason to criticize? Running an EMS agency with a fleet of vehicles, each equipped with the standard load of equipment, eats up a lot of cash. That means that an EMS provider usually has a fair amount of debt. How much debt is really none of your business, has nothing to do with the level of service provided, and has zero impact on response times. Your earlier post that this happened because the Chief was a female was laughable, but now you crossed the line to an uninformed rant.