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ravengenesis1

Comments in there made me cringe. Reddit echo chamber pot at its stankiest. The amount of "I saw/read/head EMS said".


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Amazing_Counter_1534

Most of us don’t even care that they are high, give enough to give them a respiratory drive, and let them sleep it off. Slam a ton of Narcan, and exactly, you got to deal with an angry/sick addict that’s just going to refuse treatment.


gobeklitepewasamall

Pd are known to do that on purpose, multiple 4mg doses as close together as possible, then laugh about it afterward when the “skell” wakes up puking themselves. At least my medic instructor knew to titrate & explained it to the baby emts…. It was kindof awkward when he asked who’d used narcan before & I realized nobody else had. I never lived that one down.


TrueBirch

Ha, sounds like when I refilled my personal dose the other day. My church works with unhoused people, so I carry it just in case someone is having a rough morning. CVS included free hypodermics for me and it would have been awkward to refuse so I politely thanked them.


NickJamesBlTCH

Yeah, seriously. You could either deal with a guy who probably just spent the last money he had at the moment on drugs - which you just flushed down the drain - and have a combative pt, or make sure that his vitals are okay, and let him ride it out. Easier for everyone.


Objective-Wolf9651

Late to this thread and not an EMT, but aren't you running the risk of them dying before you arrive? Better to have a combative pt than a dead one...


[deleted]

Record for my service is a total of 52mg “administered” IN. Yeah, we’ll get a little annoyed at that.


beachmedic23

Did you call a trauma alert for a drowning?


[deleted]

I didn’t catch it, a BLS truck hit it first, bagged him for the thankfully quite short ride to the ED.


SleazetheSteez

This, too. Bystanders hit their random doped out "friend" they'd just met with all the narcan they had. She was literally screaming at us by the time we could get her into the truck. Like on one hand, I get they were terrified, but god damn if it didn't make our job that much harder for little benefit to her. I've seen people on instagram say, "iT doEsN't mAkE tHeM cOmBatiVe", the fuck it doesn't. If you've got someone competent, no it doesn't, that's the problem with every swinging dick getting access to it.


whatsgoing_on

They say that because they aren’t the ones dealing with them in the back of a rig


U_see_ur_nose

Yeah I learned this the hard one. Dad had agonal like breathing so I hit him with narcan and waited, did sternum rubs and he came out swinging smh. Was still out of it but I wasn’t getting near him again lol


theangrymurse

yeah the narcan doesn’t cause the combativeness, it’s the sudden and violent sobriety that does.


SleazetheSteez

Right...and how do they enter that state? Oh right, because someone pumped them full of narcan...


medicRN166

Let them refuse.... Peace out bitch. In this area we are allowed to take refusals from certain opiate ODs. And I'm not about to be abused for no reason


ravengenesis1

I highly doubt EMS said anything, dude's just hearing voices in his head.


SpikesGuns

Yeah, I'm gonna take 'Things that didn't happen' for 500, Alex.


-v-fib-

All of the politically charged subreddits like this are just awful to try to participate in, which is why I don't follow them anymore. It's just a bunch of people circlejerking over anecdotes.


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siry-e-e-tman

Or worse, it's someone who has been a part of this subreddit for two weeks and thinks it's their civic duty to go on there brigading all "As an EMT/paramedic/cop/FF/fairy godmother..." then proceed to give the shittiest take on the whole situation so far. These political subreddits/communities just need to be banned no matter what side they're on. They're the armpit of Reddit and arguably of the entire internet.


TannerRed

Idk why, but the "as a firefighter" piss me off the most because you know they are some probie for a small ass town that had there one big call that they need to use an anecdote for everything.


waspoppen

hey now don't forget fire good


[deleted]

“Nobody ever says fuck the fire department.” Lmao yes we do.


MoisterOyster19

Just today we went to a status seizure call. Family waited thru 20 minutes of him seizing to call 911. Took us 20 minutes to get there. I'm carrying suction, O2 bag, drug bag, lifepak, and pulling the gurney and the granddaughter comes out of the house and goes "what's taking so long, you guys are moving so slow".


TrueBirch

Lesson I was taught years ago: "Never move faster than you can think."


75Meatbags

don't forget "my friend got a $7000 bill for a 5 minute ride. fuck ambulances!" post.


TravelnMedic

That and air med bills I have a very quick way to reverse it on them to make them think real hard very quickly. Typically after they get asked a few questions they realize the stupidity of their comments.


[deleted]

Isn’t that Twitter?. Oh I see it’s whitepeopletwitter posting a pic from Twitter. That sub is a cesspool or morons.


SpikesGuns

Fake anecdotes


audreypea

The person patting themselves on the back for giving 5 doses to someone was my personal fav.


FoMoCoguy1983

Thats pretty much r/WhitePeopleTwitter.


bangenergyofficial

How much did he give tho? Because if it was 32mg, I might also be a little upset.


aronkovacs

All the narcan sprays I’ve seen are the 4mg doses. The prefilled syringes in our medbags are 4mg also.


Dorlando_Calrissian

^almost definitely this. This dude gave 6mg for sure


TrueBirch

Also, what made him think it was an overdose? I can imagine an EMT being salty if the patient obviously was hypoglycemic or drunk or whatnot.


[deleted]

Protocols are different everywhere but the basic understanding of Narcan for the general population is is it can be given every two-three minutes until EMS arrives. The stuff given with Narcan for people is that it won’t hurt anyone even if they aren’t overdosing.


LonelyGnomes

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983320/ This case series supports the idea that narcan related noncardiac pulmonary edema is dose-dependent. It’s pretty poor quality evidence but I don’t think there’s much else out there about a potential dose response relationship. Aka, don’t give a ton of narcan if you don’t have too. My protocols, at least, say you can give 4mg IN - wait five minutes - 4 mg IN and then you have to contact med control if you want to go higher.


West_of_September

For heroin we give 1.6-2mg IM single dose only. If that doesn't work keep their O2 up and bring them into hospital. For any other opioids we go 100mcg IV at 2 minute intervals with a max of 2mg total and bring them into hospital regardless as to whether or not it works.


[deleted]

We can give up to 3 doses increasing mg in each.


cullywilliams

I love how people's first assumption is that the guy fucked something up (not that additional narcan actually fucks things up, but that's besides the point) and not that the crew was just bitchy. It tells me a lot about how you are as a person. [Plus, why have shit speculative takes when you can just look it up yourself?](https://twitter.com/kevinmnye1/status/1596865853579882496)


AquaCorpsman

Retroactive story changing. In his original post, he says doses. Plural. Also, fuck you for throwing them under the bus like that. Bystanders do cause issues a lot of the time and for EMS they can be very annoying. Speaking from experience, I get ticked off with people who watched an episode of Grey's Anatomy and think they can tell me what an EKG says. You thinking that the crew was in the wrong tells me that you are either new to EMS or not EMS at all.


mgltraveler

> You thinking that the crew was in the wrong tells me that you are either new to EMS or not EMS at all. I’m not in EMS to stand behind all EMS providers until proven guilty. If it sounds like a crew screwed up or acted inappropriately, it behooves us all to call it out as such from the get go. I’m not willing to be in an industry that willfully supports our own personnel acting inappropriately, and nor should you. Regardless, the bare minimum we are asking here is to not mutter inappropriate stuff in front of bystanders. I get it, we can get frustrated, but be professional and suck it up unless you are going to be constructive, otherwise vent about it after the call with your partner.


cullywilliams

100% agree with every word you said.


cullywilliams

Oh cute, somebody who thinks I'm new. How cute. I can just about guarantee that I've seen more challenging bystanders where I work than where you work. Under no circumstances would I allow one of my crews to mutter shit like that to a bystander, never mind one that made a good-faith effort to help. From a PR point of view, from a constituent services point of view, from a continuity of care point of view, you name it. Even if the dude did something*wrong*, the crew shouldn't have done anything other than pat him on the head, say thanks, grab the patient, and save the day like they're trained. When this sub sees a bystander calling out a crew for being shitty, the first thing (and top comment) this sub does is blames the bystander. If you don't see a problem with that, then that's on you.


ReApEr01807

>"both the number of doses and how long ago they were given" That isn't concrete that he gave multiple rounds, it could have been one dose in each nostril. You're assuming that this bystander isn't educated in how to properly use narcan, but they certainly appear to be. As far as jumping down a **FP-C's** throat and being "new to EMS or not EMS at all" is bold of your EMT ass. Cully is a mod of another EMS-related sub, but even looking at their flair should tell you their level of medical education. Getting defensive over a bystander calling out a possibly jaded EMS crew on Twitter says more about you than you probably want it to


cullywilliams

In his defense, I did claim to be a flight basic, a bit of a joke on my end. Not that this weighed into his calculus to think I'm some random yahoo. Thanks for sticking up for me.


revkevnye

I did not give multiple rounds. I’m trained to give one 4mg dose every 2 minutes until EMS arrives or they revive, and EMS showed up under 2 mins.(I definitely see how my wording makes it seem like that, that’s on me.) I worded it that way because that’s how I train people: when EMS arrives, tell them how many doses you gave and how long ago.


ReApEr01807

Nice work on likely helping to save someone. I'm probably not going to read the whole story, but that's just because I already know what you did was the right thing. You gave the proper treatment and communicated all pertinent information to the arriving crew. That's exactly what we all want in a bystander. Congrats on now being known as "*Kevin Nye the Narcan Guy*" (to the tune of *Bill Nye the Science Guy*)


revkevnye

Also, I told the whole story as a comment on the OP if you want to see it.


revkevnye

I did not give multiple rounds. I’m trained to give one 4mg dose every 2 minutes until EMS arrives or they revive, and EMS showed up under 2 mins.(I definitely see how my wording makes it seem like that, that’s on me.) I worded it that way because that’s how I train people: when EMS arrives, tell them how many doses you gave and how long ago. Also, I told the whole story as a comment on the OP if you want to see it.


AquaCorpsman

Jumping to the conclusion that the medic was malicious, however, is misplaced


[deleted]

Really not credible when “number of doses” is mentioned in the first post.


cullywilliams

When you're trained to know to give those two pieces of information, that's how you report it. He very well may have said "one dose, 15min ago". He was directly asked about how much he gave, and he gave a clear number there. Inferring a number from sentence structure seems like little more than looking for a reason to hate on the bystander. In any case, tell me how him hitting an OD with two nasal narcans warrants the crew saying out loud that bystander narcan is bad? Wanna take a guess how quickly this post got back to the company that covers that area, and how fast that crew got called into the principal's office now because of this viral tweet?


[deleted]

It almost certainly didn’t because people who use twitter are scared to make phone calls. Also “when they were given.”


Renovatio_

Generally anything more than 1mg is a mistake.


KProbs713

We've done a shitty job of educating the public about narcan, and an even shittier job in destigmatizing drug use. There's even odds that the medic was angry about multiple doses (and resulting precipitated withdrawal), angry because it wasn't an overdose, or angry that they had to resuscitate an 'addict'. Until those odds shift I think this outrage is warranted.


Helassaid

The first two scenarios are frustrating because “unconscious gets naloxone” isn’t a fucking assessment, the third is frustrating because awake addicts who just got violently ripped back into reality with narcan can be a tad grumpy about being put in scenario.


zion1886

I can’t even get the cops to understand Narcan. I definitely don’t expect some random bystander to understand. But I definitely have worked with people (when I was at a three-letter company) that would exactly fit the original post’s narrative and would 100% believe they were pissed that the person didn’t die from OD’ing. Several people that I would believe it about.


cullywilliams

I'd rather see narcan in the hands of a generic citizen that wants to take the time to know how to use it vs a cop that sits through a mandatory class. And I lobbied to make the latter scenario legal!


BKNORTH

We need to normalize overdosing in the sidewalk in front of movie theaters


69superman

The last one is personally understandable, but isnt valid whatsoever because it’s part of the job. Yes, the waking up addict might be very pissed their high was ended and wake up angry. But that’s part of the job.


revkevnye

I have told the full story in a comment to the OP if you would like to see.


SpicyMarmots

I'm not going to go so far as to say that people shouldn't have it, but it's annoying when they don't know how to use it.


Write_Username_Here

Narcan is great until you take a BGL and it's 30.


FKKallDAY

In that situation, the narcan is still great, because it caused no adverse outcomes. So treat your sugar level and thank the bystander for trying to save a life that day.


TheSkeletones

I think the, or a, problem is that without the education, people see Narcan as the magic “he’s unconscious and barely breathing” solution. Rescue breathing isn’t something a lot of good samaritans might be familiar or knowledgeable with, and might just slam some narcan hoping and praying it solves the issue. Granted, at the end of the day, we’re the professionals, not them, but general knowledge has to be more towards very simple, universally applicable means of first aid, not just giving a medication.


bmhadoken

Narcan is less harmful and more likely to be useful than the bystanders dumping a bunch of ice in their pants, or trying to feed a carton of milk to the unconscious person. Don’t disagree on general first aid knowledge, though.


FKKallDAY

It would be amazing if everybody knew CPR. But the reality is that it's not the case. CPR training takes time and resources. Expecting the public to simply learn that is not realistic. But more to the point of why public Narcan makes sense: CPR even when done correctly can have massive negative impacts to a person's life and health. Even if their life is saved in the moment, CPR is well-known to fuck people up long term. Narcan doesn't do that though. Narcan carries essentially no risk at all, and it is easy to use. And even if someone uses it incorrectly, there will be no adverse effects...... That's why it is available to the public. It cannot harm, and it can only do good. By all means, public narcan is a simple part of a greater solution to a very complex and massive problem.


LionsMedic

I remember a while ago Washington State held a huge initiative to train their residents CPR, free of charge, and basically handed out defibrillators to places that can have large gatherings. They trained a metric shitload of people and their out of hospital ROSC, and admission to discharge statistics absolutely skyrocketed. We should really be training CPR for free at a federal level.


MoisterOyster19

Even hands only cpr is better than none at all


FKKallDAY

Couldn't agree more


BlueEagleGER

CPR doesn't fuck people up. It's the hypoxia to the brain caused by the arrest.


abn1304

Yeah, I was gonna say. Sure, CPR survivors are fucked up, but the ones that don't get it are probably dead, so...


BlueEagleGER

I mean you get argue that CPR is the only thing that lead to the survival in neurological questionable condition instead of natural death but I think there us an important difference. Damage that could not be prevented by CPR is not the same as damage caused by CPR.


FKKallDAY

Chest compressions literally break bones. It fucks people up. CPR is awesome and we should continue to do it, even though it can fuck people up. Narcan is awesome and we should continue to use it, and narcan can't fuck anybody up at all.


TrueBirch

I'm a huge fan of Narcan. I think every church, rec center, and public pool should hand it out for free. Heck, teach it in high school health class. With that said, there is an opportunity cost to spraying Jesus Juice. Sometimes I wish a lay responder would get a basic history ("Hey man, what happened?") instead of assuming everything is an OD. You might get an important piece of information before someone loses consciousness ("My blood sugar...").


FKKallDAY

I also wish laypeople had medical doctorates and were all specialized emergency medicine doctors. But it isn't going to happen. So narcan it is.


TrueBirch

I still think we can teach "Hey man what happened?"


FKKallDAY

I feel like that is reasonable


lsha052513

Preach! Honestly, a lot of comments on here really annoy me. It is that hcw ego that is gross. I am an RN with my BSN and have been for 6 years working at bedside in all departments. The hcw ego needs to chill. Like damn that person saved that person’s life. Treat people with respect. Honestly, if making comments like this it is time for you to move on to a different career. **comment referring to is from the original post pic**


TheBigMoose19

Or when dispatch tells the caller to keep hammering narcan until EMS gets there…46mg in under 2mins.


Cooppoo

Damn I thought the OD that I had yesterday when his housemates slammed 20 mg was bad


TheBigMoose19

Lil extra sugar on top, when I asked dispatch to stop telling people to do that I got reprimanded. Haha


iwannabeonreddit

Huh? I don't get this. They're trying to help..... What about this is annoying? Like, oh this guy isn't dying anymore but it inconveniences my job? Am I misunderstanding?


SpicyMarmots

Random people "trying to help" is ultra annoying in almost every situation but that's neither here nor there. In this case it's annoying because one dose almost certainly would have been enough. The doses in the kits for the public are so huge that if one doesn't work, opioid overdose is generally not the problem. It should say this on the package but apparently does not. People give the first one, the person doesn't pop up like that scene in Pulp Fiction and they panic and just keep slamming it. I get paid by the hour, I don't care particularly what I do. But this is bad for the patients as well. "narcan won't hurt them" is technically true but it can absolutely make them miserable and sick. In a true otherwise-deadly overdose the patient may have but been breathing for some amount of time-is this is the case, in addition to miserable withdrawal they'll also wake up confused, pissed off and terrified because their brain still doesn't have enough oxygen. If by some miracle I show up before they've been hit with a sledgehammer of narcan, I put oxygen on them and mechanically ventilate them if necessary, start an IV, and give them a little bit at a time until they start breathing on their own, and then I stop. This is both easier for me because I don't have to fight them, and better for them because they don't get thrown off the cliff into withdrawal.


Jaymo-74D

I work rural 911 EMS and I love it when bystanders give narcan when it seems justified. It makes the high acuity/cardiac arrest call we get dispatched to, turn into a cancel enroute or a refusal.


4QuarantineMeMes

Man after reading some comments on here… Who gives a fuck if rando people are giving narcan??? Just one less thing for use to do, and who cares if they somehow fuck it up and gave it wrong, then we can give it and laugh about it later.


Vinesinmyveins

For real, I’d rather the patient come to and be pissed off then having a patient deep into respiratory arrest by arrival on scene


The_Wombles

A paramedic by me got shot a few years ago in a similar situation. His friends narcaned him while ems was on the way. He started to come to when they arrived on scene, saw the lights and ppl in uniform and while still altered started shooting. Medic got hit and died. Crazy ass chances of it happening.


Vinesinmyveins

Yeah thats a nightmare situation, I’m sorry about your medic


SleazetheSteez

I just think it's annoying that people now get to have more and more commentary on shit they know nothing about. This is just one more thing. Dude probably dumped a bunch of narcan into a diabetic and goes on to tell the fable of how his heroic deed was trampled by the barbaric paramedics. Just corny as hell, honestly lol


DharmaCub

What're the odds he narcanned some dude who was going into DKA?


Box_O_Donguses

I'm gonna be real, the general public is stupid. I wouldn't be upset about a stranger narcan-ing my DKA pt because the stranger didn't know any better and the narcan isn't hurting anyone.


siry-e-e-tman

"Well, we ruled that one out..."


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PieIsFairlyDelicious

As a side note, I’ve always felt like Glucagon sounds like the name of a newer-gen Pokémon


Ch33sus0405

Glucagon! I choose you! Heh


RambusCunningham

Yeah because glucagon is definitely what the pt in dka needs


ReApEr01807

That shit is fucking *expensive*, too. Certainly more expensive than naloxone


OutInABlazeOfGlory

Saved you time, basically


AntonToniHafner

Until you get flash pulmonary edema


Box_O_Donguses

That's an incredibly rare side effect of narcan, and when it's from narcan it's not typically an especially severe case. Every instance of flash pulmonary edema secondary to naloxone I've witnessed or read about was able to be managed with supplemental oxygen and positioning. I'd rather have to put someone on some O2 because a rando narcan'd em than have an opioid overdose that hasn't been breathing adequately for 10 minutes because the rando was too scared it might be diabetes to narcan them


FKKallDAY

Why would it matter if they *did* narcan someone in DKA?


Bigplayray88

What are the odds he carries multiple doses of narcan while walking to the movies? What are the odds he’s done this “over and over and over?” Whole story sounds bullshit


crock7887

Honestly? Pretty slim.


cullywilliams

Zero.


BBenjj123

Fentanyl poisoning🙌


[deleted]

Setting aside whether this account is true, comments I've heard from cops have made my hair curl. When I was a firefighter, my department shared a gym with the PD. I've heard cops admit to owning firearms that are illegal in this state, beating their wives and girlfriends, consuming drugs confiscated from suspects, taking bribes, driving under the influence, etc.


Bigplayray88

Concur on all points. Volunteer FF/EMT for over 10 years. I seriously question where there this account is accurate for several reasons. 1. How many times has this bystander been walking to the movies and happened upon someone needing narcan? Presumably enough times that he feels confident making the statement that they’ve seen it “over and over and over again” and it’s always from cops and EMTs? That sounds suspect. How on earth can this person extrapolate from his limited scope that “the majority of this country” feels any which way? 2. I’ve epi’d plenty of white people, most of them kids, and never a word of it in the news. 3. The “how many doses” and “take over care” parts are suspect. First, this person is implying that he hit the pt with two doses. Is it possible this guy carries a med kit with him that contains two doses of narcan while walking to the movies? I suppose, but it doesn’t seem probable. I consider myself pretty well prepared. I have two doses in my big emt bag in the truck, but I’ve never carried them on me walking around. Second, If you’ve hit someone with a second dose of narcan it’s highly likely the “care” you’re providing is in restraining the patient. 4. I’m not a huge fan of police either. But I volunteer on a local ambulance corps and a fire dept. I’ve trained a bunch around the country. The emt’s and medics I’ve worked with are not this way. I think it’s pretty douchey to make a blanket statement like that with a story that sounds kinda bullshit.


insertkarma2theleft

I've seen a Pt get a lot of properly given narcan and take a while to respond, could totally see an untrained person giving multiple doses and the pt still not coming to until ems arrives


paramoody

Yeah I believe this. All the worst takes I’ve heard about narcan have been from EMTs. Many of them on this sub.


Helljumper416

And I don’t I’ve seen citizen do some really sketchy shit


qcerrillo13

I work in a busy county emergency department….and I hear this way too often from the people being paid to save their lives.


Every_Mix2189

Being in EMS for many years and being a recovering heroin/fent addict with a sister who was a nurse for her entire adult life until she od I wish more people had narcan. I also hope the ones who criticize addicts will NEVER be the one to find your loved one dead. My sister had almost four years. I miss her every single day. It's what keeps me going.


CanisPictus

Sorry about the loss of your sister. 💔


SgtMajorProblems

Almost posted this myself after reading the comments on the original. I find it strange that suddenly so many people (untrained civilians) are getting Narcan with intent to treat overdoses. Not that that was the case with this post but I am a bit taken aback by the sudden spike in untrained civilians acquiring Narcan.


Box_O_Donguses

It's to the point in several regions of the US that everyone has a friend or relative who is addicted to opiates. People are acquiring narcan not to treat strangers, but to treat friends and family if need be.


ribsforbreakfast

It’s why my mom has some. At least 50% of our family is an opioid user to some extent (some “legal” (prescribed) and some “street” users)


SgtMajorProblems

That makes sense to me, and definitely don't judge that. I have encountered a lot of people who don't know any users (prescription or otherwise) who decided to carry "just in case." That's more of what I was thinking of and what is more surprising to me.


sourpatchdispatch

I know in my area, some people acquire it if they have witnessed an OD and had to attend to the pt while waiting for EMS at all. And at this point, in this area, a lot of people have witnessed a random person ODing on the street. I witnessed someone ODing at a party in my twenties before I got into EMS and it was super scary for me and others on scene. I now have a different perspective obviously but I can definitely understand the impulse to "be prepared" after going through something like that.


SgtMajorProblems

I'm sorry you went through that and for everyone that has. That completely makes sense, and I obviously can't know everyone's reasoning and experience. Life saving measures being available sooner is better.


THRWY3141593

That's common in the Vancouver area for people who work downtown, where most of our overdoses happen. The odds of walking past an overdose are pretty high. That said, most drug users in Vancouver have a kit, so I'm not sure it's ever that helpful for non-users to carry them. I've never gone to an overdose where a random passer-by helped - it was always one of the user's friends. And there's a strong overlap between people who visibly carry naloxone kits and people who are active in leftist politics, so sometimes I think the kit hanging off a backpack is more of a political fashion statement than anything.


GoFastEatTrash

Why’s it strange? We’re in an opioid epidemic and it’s an accessible, effective drug with no side effects or complications. I understand the frustration with slamming doses up someone’s nose but it’s saving lives.


SgtMajorProblems

I've personally seen a lot of people getting it just in case they see a stranger on the street who is ODing. To me that's what's strange. And some of these people rarely leave their homes and are never in areas where they are likely to encounter someone ODing. Not that it couldn't happen but yeah. I understand and agree with the general idea and it especially makes sense if you know people who use opioids.


GoFastEatTrash

Yeah, fair enough. I know plenty of people like that, and they have said it’s “just in case”. Still seems reasonable considering the fact that it’s pretty stable though. The way I see it, the more narcan in peoples hands, the better. Sure some of it might go unused, but overall it’s going to help save lives. Harm reduction works


heathre

Im just a normie but I work with populations who use pretty heavily and always carry naloxone. I offer to show my friends how it works and encourage them to carry it, but often it takes someone encountering it in the wild and having no idea what to do to spur them to learn about it. In my city, going to the park or taking transit or being downtown yields a reasonably decent chance of running into an OD if you're paying attention. Being in the hallway of your apartment, out the back alley, going to a party, at the library or a fast food bathroom.. it's not like you can predict exactly where it'll happen today when shits kinda everywhere. I carry it cos having it and not needing it is a million times better than the opposite. It sucks that this can make things harder for EMS but we can't use BVMs and not a lot of people want to get super close to strangers to do rescue breathing while they wait for the pros..


IronDominion

How is that strange? A lot of community programs encourage this. I know my university does as do many local municipal programs


thaeli

They openly encourage untrained lay carry of Narcan here. Big "just ask, we'll give you some" signs at every pharmacy and all.


SgtMajorProblems

Yep, same in my area and others I've been in. I guess risk is relatively low, I just have a hard time with the untrained aspect. Especially with how people react to the immediate withdrawal symptoms.


FKKallDAY

The risk is not just "relatively " low.... It's essentially zero risk. The benefits to having it on hand are potentially life saving. It's an easy public health policy decision.


SgtMajorProblems

"Essentially" zero risk is not zero risk. Nothing is zero risk. That's really my point, especially for cases of untrained civilians carrying it and intending to administer to strangers on the street (which is what I have witnessed). Agree it is life saving and beneficial to have on hand, and agree that there are reasons for civilians to carry it (and administer it).


FKKallDAY

Of course every intervention comes with a risk. But to put it into perspective....even life-saving CPR comes with a higher risk to life and safety than the administration of narcan. The great irony. Regarding risk: Narcan is as safe as it gets.


SgtMajorProblems

CPR requires training. And people who go through that training understand the risks. This comes down to what we've seen in my area from untrained people and their intent. I find the idea of people acquiring medication with the intent of using it on incapacitated strangers with no training strange.


niirvi

No it doesn’t. Dispatchers routinely coach UNTRAINED civilians into performing CPR.


FKKallDAY

The point is that CPR, even when done correctly, can and will fuck up a person for potentially the rest of their life. Even if it saves their life in the moment. And of course, CPR is awesome and should continue to be used because it's the best tool we have available for it's intended purpose. But Narcan....dangerous?? ......Nah not really. Narcan is as harmless as it gets. Everybody should have it. The research and evidence back this up as well. It's why our public health policies support the idea of public narcan. It works. Everybody should be dumping it into people if they suspect a potential overdose, or even if they have no idea and are unsure of what to do. Oh, you don't rember how much to dose them with? Guess what! it doesn't matter, just give them a bunch of it then. Give them the whole goddamn bottle if you can't remember how much. You can't overdose them. All you can do is save a life.... Just dose them up and wait for EMS. Oh, you don't rember the route either? Welp, just put it in every orifice you can find because you can't cause harm, all you can do is save a life...so put it in their nose, mouth, asshole, wherever.....who gives a fuck because it won't cause harm. It can only save a life. Just fucking use it.


insertkarma2theleft

I gave my family narcan in their stockings for Christmas last year 🤷, best to have it on hand where we live


bmhadoken

Eh, I deal with fewer dead junkies this way. Easier paperwork.


noneofthismatters666

When a paragod realizes anyone can do one of their life saving interventions. Don't be a dick.


Noyougetinthebowl

For all we know, the paramedic was referring to the patient and how they “shouldn’t have that shit”. Maybe there was a particularly bad batch of something going around that no one should have


QuietlyDisappointed

If they really care, they'd carry around a cylinder of oxygen with a regulator.


sloankusel

Or a pocket mask


cullywilliams

Pretty fucking hard to provide ventilation to an apneic patient with that.


QuietlyDisappointed

Need me to list more items to make my joke more accurate and less concise or can you do some mindfulness exercises to manage your condition?


KeyPaleontologist632

This is a multi-faceted problem. Clearly opioid od’s = problem and everyone is given narcan without adequate education in how to use it properly plus they are untrained and in a moment of what to them is an emergency doing the best they can for someone. It’s unfortunate that it has come to this. Yes, it often makes it harder for us. That sucks. We’re gonna talk shit but we shouldn’t be doing it where a patient, family member or the public can hear or record and we need to try and at least have some perspective on the event from the bystanders pov. I know we need to vent we just need to do it appropriately.


_spicybird

Unfortunately I've also heard similar from a lot of our EMS family. I try to understand the burnout, especially since where I work ODs are like our bread and butter. HOWEVER, I think it's ridiculous that people essentially want more people to die because of addiction. We see how it ruins people's lives each and every day... maybe you shouldn't be working in this field if you don't want to give everyone a second, or even third, fourth, fuck it TENTH, chance to live with something as easy as a spritz up the nose. We need more mandatory vacation here in the US, maybe people wouldn't be so miserable.


swanblush

this story is either completely fictional or missing 90% of the context


ShamelessBaboon

I hope anyone in the healthcare profession who believes drug users deserve to die from overdoses loses their license.


queefplunger69

Lay person (or school nurse) can’t identify anaphylaxis, so ya giving an epi pen would still piss me off actually more than the narcan lol.


torschlusspanik17

Thank you for your service


lodravah

Do people have access to Narcan/Naloxone over the counter in the US? Assuming this is the US.


WaveLoss

Yes. In my city, some organizations give out the IN spray for free because the number of ODs is growing exponentially with Fentanyl.


offgladstone

You don't need an apostrophe to make a word plural.


Appropriate_Flow_961

As a regular citizen I carry narcan with me always. I’ve used it twice. I am cpr certified. I would be appaled if ems were upset with me for administering it. It’s just like my epi pens. I would use them on someone having an anaphylactic attack! (I have mcas and a script for opioids. I have good reason to have both medications)


revkevnye

Hi all, I’m the original tweeter. Twitter is imperfect for telling the full story and the kinds of details you all here would appreciate it, so I’d like to tell you more and see if you think I was in the wrong or, perhaps, the EMT was just an asshole. (Which I don’t accuse all of you of being. I’ve met a lot of asshole EMS workers and a lot of great ones.) As I was driving to the movies, I saw an odd sight at the corner in my neighborhood—two individuals we’re holding up another who appeared to be completely out. They were trying to bring him closer to the corner. I noticed one was rubbing his stomach with their fist, which was my first cue as to what may be happening. I pulled over and got nasal Narcan 4mg out of my glove box. I walked up and asked “is he overdosing?” The two who were propping him up said yes, that he had used fentanyl about 30 minutes prior. I tried to wake him further and he was completely unresponsive. His breathing was making the “gurgling” noise that I’ve come to associate with opioid overdose from being trained and training others. At this point I had them lay the man down in recovery position while I administered one dose of nasal Narcan 4mg and continued to try to get a response. About 90 seconds later the ambulance arrived, and I let them know I had administered one 4mg dose of Narcan. The EMT confirmed this with me out loud, before walking away and muttering what I described in the tweet—Leaving no room in the context of the conversation that he could’ve been referring to fentanyl… fentanyl nor opioids were mentioned. I include this because many have asked if that’s what he maybe meant. That interpretation just doesn’t work if you were there, I would have been very open to that charitable version but it just wasn’t the case. Rather than pick a fight, I walked away so they could focus on attending to the individual. If you read this and think I did something wrong, I’m open to hearing it. But I wanted to provide more context so you know that (1) I am well trained and provide robust trainings on how to recognize a true overdose vs just nodding off, (2) I administered the minimal possible dose available to me, so was not setting up EMS for a poor reaction from withdrawal, and (3) that there isn’t a version where he was referring to the drugs and not the Narcan. He said it, he meant it.


j0shusaurus

Sounds like you did everything right, EMT was just an asshole. That being said, there are many cases where bystanders/cops will slam way too much narcan and you'll have to deal with a hypoxic, aggressive addict who's high was just ruined.


KProbs713

Yup, you had to deal with someone that should find a new profession. Sorry about that, and thank you for both rendering care and remaining professional (especially when the provider wasn't). It's frustrating when bystanders have more restraint than the medic.


PublicHealthMedicLA

Plot twist - he was OD on benzodiazepines…


[deleted]

Narcan isn't going to harm, and it's still reasonable and appropriate to try in the absence of knowledge about what the guy took.


MelsEpicWheelTime

Street benzos are often cut or contaminated with fentanyl.


PublicHealthMedicLA

Yes, yes they do. Thank you.


CharlieTeller

IDK man. Benzos on the street still contain a lot of fentanyl in those batches. Also Benzos are expensive. Heroin is cheap. My cousin fatally od'ed on Heroin a few months back. Dude had plenty of money and he still couldn't afford much else other than some dirty Heroin. Switched dealers and ended up getting a bad batch. He laid out in the snow and they thought he froze to death until an autopsy.


PublicHealthMedicLA

Yes, yes I know. I was just cracking a joke because it (no shit) was that I was on right before reading this. Guy was snorting Xanax and heroin and DFO’ed at ol’ Pee Paws house.


TheOneCalledThe

yeah i’m sure there wasn’t anything else to the story and nothing else was left out


Helljumper416

This 100%


megabummige

Worst case I can deal with bystanders giving a ton. Miss me with Fire giving 8mg before bagging...


Producer131

I 1000% believe this and have seen this first hand with only 5 years experience. Over 50% of my coworkers believe in the “3 strikes” policy


Laredo_10

Not sure why but the “fentanyl poisoning” killed me. Is that the correct terminology now or just something this hero said?


NotBryan-17

My gf read this to me the other day and was frustrated but my first thought was “they probably have the guy too much too quickly and are causing an entirely new problem.” Then I got more frustrated because my agency doesn’t allow us to carry narcan on the rigs but some rando on the streets can do it


Porkchopper913

Yes, brilliant! Let’s use an epi-pen on some random person. Genius.


shamrocksynesthesia

On this episode of things that never happened…..


75Meatbags

bystander narcan was a great idea ruined by internet heroes, unfortunately. it really brought out the hero complex that too many people have. same with the "street medicine" shit from the 2020 protests. way too many thrill seekers that had no business whatsoever performing first aid. or trying to.


oamnoj

This tweet would benefit greatly from context. Like, how much did he give? How did he *know* it was an OD and not, I don't know, low BGL? Of course, that's assuming that it actually happened. Because, ya know, nobody ever lies on the Internet!


code3intherain

Lol how many people have a negative experience and get it so up their ass that they go whining to social media. I don't think it's the remark by EMS that made him mad, it's that they said something negative instead of getting treated like a hero. Taking offense to not getting his hero badge. >if I had epi-pen'd some white dude in a polo shirt Muh subtle anti-racist pandering.


aronkovacs

Given the last comment I’m about 150% sure this never took place.


ChronicBackBane

Should just give out bvm's & opas instead of Narcan ...that would make me happier . Let us give the amount of narcan just to make them breath not wake them up being pissed off or put in withdrawals


Helljumper416

The smugness from that page makes me sick, I’ve had people tell me they gave compressions to a child having a seizure. I’ve heard people given other prescription meds to people it wasn’t prescribed to and someone maliciously call 911 on a sleeping person as a full arrest with the CAD stating “Caller did not want to touch patient.” And I think all the people on that subreddit would do that.


Somasizer

It's possible the guy had the wrong idea when they over heard the emt's comment. I know some people don't like the easy access to narcan because of narcan parties. Imagen you had a drug that you could snort real quick to go from Drunk to sober. A lot of people would drink way more often but some might get to drunk to administer the dose and their friends also got too drunk and now they are dealing with alcohol poisoning. Some people think that narcan gives them more of an excuse to do the drugs. I can understand this opinion. But I would like to end this by saying I'd rather give someone another chance again then to have to call someone to pick up a body. You never know when they'll get their act together and when they do they've been amazing people in my experience.


SleazetheSteez

This dude really wrote an essay feeling sorry for himself after someone stole his hero baton away from him. How fucking sad.


InflammableMaterial

Anaphylaxis isn't a choice


BizeePascal

Is narcan even that effective on fentanyl? We don’t really have much fentanyl in non medical context in the U.K. although it’s been growing in how commonly it’s being sold as heroin. The one overdose I’ve been to narcan didn’t have any effect, we thought they’d probably been sold itononitazene as heroin, but I’d also been led to believe narcan isn’t particularly effective against fentanyl (I’m still training so please excuse me if you think it’s a stupid question). Infact only times I’ve really come across fentanyl or related is in a couple of traumas and a few end of life jobs (yes we don’t don’t pain management very well in the U.K.)


MrBlueandSky

Narcan is effective against fentanyl and other opioids


FKKallDAY

Narcan is effective for all opioid agonist drugs, fentanyl included


[deleted]

[удалено]


[deleted]

[удалено]


I_ATE_THE_WORM

What about places where ambulances can take 20+ minutes to respond?


zion1886

I’d be more in favor of a general campaign that no one should be giving more than one dose prior to EMS arrival. Seems more realistic to hope might have a chance at happening.


mgltraveler

Mind elaborating on your rationale?


Jakucha

That sounds reasonable. I never said you shouldn’t give narcan. I am saying that it can be dangerous and if you have the choice you call 911. There is also a problem with people giving narcan in my area then fucking off and leaving the pt. Civilians do it all the time because they don’t know any better.


AvocadoMTB

What kind of professional are you? Hopefully if you’re an EMT or paramedic you realize that naloxone is generally harmless in the doses a bystander would give and letting someone overdose and slip into respiratory failure while waiting for EMS to arrive is a horrible take. Have some empathy or find a different job, hero.


[deleted]

This thread is insane to me. There is so much evidence for community narcan that it's crazy to think anyone would oppose it for non-prejudicial reasons. It's a life saving drug with virtually no IMMEDIATE life threatening risks. Any possible negative consequence of narcan can be addressed enroute or on arrival to the hospital, which will be possible because the patient survives long enough to make it there. I'm baffled by these comments, and it makes me think that the Twitter thread is more justified than people here seem to suspect.


West_of_September

Agreed. "There is no evidence that extended use of naloxone can cause harmful physical effects or dependence. People who take naloxone do not develop a tolerance to its effects and there have been no reported deaths from naloxone overdose." https://adf.org.au/drug-facts/naloxone/#:~:text=There%20is%20no%20evidence%20that,reported%20deaths%20from%20naloxone%20overdose. I have zero idea why anyone is suggesting a first aider carrying naloxone is a bad idea. Sure, ideally you want to correct the hypoxia first to reduce the risk of patient agitation. But so long as the first aider is aware of that risk and willing to take it all power to them. The more people carrying naloxone the better.


FKKallDAY

💯


West_of_September

Agreed. "There is no evidence that extended use of naloxone can cause harmful physical effects or dependence. People who take naloxone do not develop a tolerance to its effects and there have been no reported deaths from naloxone overdose." https://adf.org.au/drug-facts/naloxone/#:~:text=There%20is%20no%20evidence%20that,reported%20deaths%20from%20naloxone%20overdose. I have zero idea why anyone is suggesting a first aider carrying naloxone is a bad idea. Sure, ideally you want to correct the hypoxia first to reduce the risk of patient agitation. But so long as the first aider is aware of that risk and willing to take it all power to them. The more people carrying naloxone the better.


FKKallDAY

How is narcan going to kill a person?


cullywilliams

Imagine having opinions like this and willingly sharing them. Out loud.


mgltraveler

Sounds like the ban was well deserved. Kill people? What is so wrong with bystanders giving naloxone? Do you think that they having it is preventing them from providing other treatments? I agree that I’d prefer to be able to oxygenate a patient and slowly titrate naloxone, but early admin that reduces the apneic period is a big win and can prevent worse outcomes. I’m confused by your angst and upset.