Overdose Response Training Shepherdstown Fire Department Inc Educational

  • Slides: 29
Download presentation
Overdose Response Training Shepherdstown Fire Department, Inc. Educational Institution April 2019

Overdose Response Training Shepherdstown Fire Department, Inc. Educational Institution April 2019

Agenda 1. 2. 3. 4. Know how opioids work Recognize an opioid overdose Respond

Agenda 1. 2. 3. 4. Know how opioids work Recognize an opioid overdose Respond to opioid overdose o o o Getting help Rescue breathing Administering naloxone Questions

Marshall De. Meritt, MS, NREMT • Grew up on a goat farm in Luray,

Marshall De. Meritt, MS, NREMT • Grew up on a goat farm in Luray, VA • Undergraduate Degree from Shepherd University • Joined Shepherdstown Fire Department in 2006 • Elected as EMS Chief in 2014 • Master of Science from WVU • WV Office of EMS Emergency Medical Technician • National Registry Emergency Medical Technician • National Association of EMS Educators Instructor • WV Office of EMS Instructor • Firefighter, Fire Officer II, and Rescue Technician • Father of 3 (2 + a dog), Husband to Krystle

Opioid Receptors, brain Opioid How Opioids Work Shepherdstown Fire Department Educational Institution Overdose Response

Opioid Receptors, brain Opioid How Opioids Work Shepherdstown Fire Department Educational Institution Overdose Response Training

Opioids By Definition • Opioids are sedative narcotics • They are used in medicine

Opioids By Definition • Opioids are sedative narcotics • They are used in medicine mainly to relieve pain • Opioids repress the urge to breathe • When someone is having an opioid overdose, they stop breathing

Hierarchy of Opioids Natural Opioids Semi-Synthetic Opioids Fully Synthetic Opioids Opium Morphine Codeine Heroin

Hierarchy of Opioids Natural Opioids Semi-Synthetic Opioids Fully Synthetic Opioids Opium Morphine Codeine Heroin Hydromorphone Hydrocodone Oxycodone Fentanyl Methadone

The Chemical Anatomy Oxycodone Hydrocodone Heroin

The Chemical Anatomy Oxycodone Hydrocodone Heroin

Opioid Receptors, brain Opioids Overdose Shepherdstown Fire Department Educational Institution Overdose Response Training

Opioid Receptors, brain Opioids Overdose Shepherdstown Fire Department Educational Institution Overdose Response Training

What puts people at risk for ODs? • Mixing drugs- including alcohol • Changes

What puts people at risk for ODs? • Mixing drugs- including alcohol • Changes in Tolerance • Physical health deterioration • Previous experience of non-fatal overdose • Variation in strength and content of ‘street’ drugs

Really High or Overdose? Really High • • Pupils pinned Nodding, but arousable •

Really High or Overdose? Really High • • Pupils pinned Nodding, but arousable • • • Responds to sternal rub Speech is slurred Sleepy, intoxicated, but breathing • 8 or more times per minute Overdose • • • Pupils pinned Not arousable • No response to sternal rub Breathing slow or stopped • • Less than 8 times per minute • Blue lips, blue fingertips May hear choking sounds or a gurgling/snoring noise

Pinpoint Pupils: #1 EMS Indicator (a) Pinpoint and diaphoretic; (b) normal

Pinpoint Pupils: #1 EMS Indicator (a) Pinpoint and diaphoretic; (b) normal

General Overdose Symptoms • • • Diaphoretic (Sweaty) Face very pale • • •

General Overdose Symptoms • • • Diaphoretic (Sweaty) Face very pale • • • Pulse (heartbeat) is slow or not there at all • Breathing is very slow, irregular, or has stopped • SOAKING WET or ICE CUBES Blue skin tinge Body very limp Throwing up Passing out - unresponsive Choking sounds or a gurgling/snoring noise

Opioid Receptors, brain Opioid Respond to Overdose Shepherdstown Fire Department Educational Institution Overdose Response

Opioid Receptors, brain Opioid Respond to Overdose Shepherdstown Fire Department Educational Institution Overdose Response Training

Recognize overdose symptoms + Recognize drug paraphernalia/Recognize the drug Recognize need for Naloxone Look

Recognize overdose symptoms + Recognize drug paraphernalia/Recognize the drug Recognize need for Naloxone Look for symptoms, but if uncertain- land on the side of Naloxone

NALOXONE (Narcan) ü ü ü Naloxone knocks the opiate off the opiate receptor- it

NALOXONE (Narcan) ü ü ü Naloxone knocks the opiate off the opiate receptor- it does nothing other than blocking opiate receptors Temporarily takes away the “high, ” giving the person the chance to breathe Naloxone works in 1 to 3 minutes and lasts 30 to 90 minutes

NALOXONE (Narcan) • Naloxone can neither be abused nor cause overdose, only contraindication is

NALOXONE (Narcan) • Naloxone can neither be abused nor cause overdose, only contraindication is known sensitivity, which is very rare. • Naloxone can cause IMMEDIATE withdrawal symptoms such as: • Anger / Combative Behavior • Depression • Suicidal Tendencies

5 Step OD Process 1. Maintain Scene Safety 2. Alert EMS 3. CPR –

5 Step OD Process 1. Maintain Scene Safety 2. Alert EMS 3. CPR – Rescue Breathing 4. Administer naloxone 5. Monitor and Support

Overdose Treatment • Scene Safety is paramount • 1 patient is easier to manage

Overdose Treatment • Scene Safety is paramount • 1 patient is easier to manage than two • Assess victim’s signs & symptoms • Call for EMS support • Stimulate the person - sternal rub • If not breathing, do not delay rescue breaths

Overdose Treatment • • • Checking for a pulse. • No more than 10

Overdose Treatment • • • Checking for a pulse. • No more than 10 seconds. If no pulse? Then initiate CPR • 100 -120 per minute Rescue Breathes • • Use A Mask/barrier 30: 2 ratio with compressions

Overdose Treatment • Administer Naloxone (Narcan) Mucosal Atomization Device (MAD) Prefilled ampule of naloxone

Overdose Treatment • Administer Naloxone (Narcan) Mucosal Atomization Device (MAD) Prefilled ampule of naloxone Luer-lock syringe

Overdose Treatment • Administer Naloxone (Narcan) STOP: Practical Application

Overdose Treatment • Administer Naloxone (Narcan) STOP: Practical Application

Narcan Administration • Atomize Narcan into Nose • 1 mg per nare (half per

Narcan Administration • Atomize Narcan into Nose • 1 mg per nare (half per nare) • • Its easy and convenient • Delivery route has advantages: • • • The nose is a very easy access point for medication delivery (even easier than the arm, especially in winter) No shots are needed It is painless It eliminates any risk of a needle sticking to you

Overdose Treatment • Monitor and Support • If breathing remains absent or slow (<

Overdose Treatment • Monitor and Support • If breathing remains absent or slow (< 8 per minute), continue rescue breathing • administer 2 nd dose • If breathing restored, then recovery position • Get an AED – just in case

Recovery Position

Recovery Position

General Questions • Will Naloxone work on an alcohol OD? • No • What

General Questions • Will Naloxone work on an alcohol OD? • No • What if it is a crack/cocaine overdose? • or speed/methamphetamine Narcan won’t work, but won’t hurt. • Are the ambulance and hospitals using the Nasal Naloxone? • Yes… and No.

Questions? Contact Information: Marshall De. Meritt, MS, NREMT EMS Chief, Shepherdstown Fire Department emschief@shepherdstownfiredepartment.

Questions? Contact Information: Marshall De. Meritt, MS, NREMT EMS Chief, Shepherdstown Fire Department emschief@shepherdstownfiredepartment. com (540)742 -8190 Shepherdstown Fire Department Educational Institution Overdose Response Training