EMS Tips – Naloxone Administration – Hydrant Access

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1. Layperson administration of naloxone increasing in New Hampshire

In 2017 the volume of naloxone administered by EMS personnel decreased in Manchester, N.H. The amount administered by laypeople increased.

“Number of overdose deaths in Manchester decreased by 27 percent in 2016, according to Chris Stawasz, regional director for AMR in Nashua. However, total overdoses, including non-fatal incidents, rose 11 percent.”

Even more remarkable is the number of visits by opioid addicts to 10 fire stations that are “Safe Stations

“Safe Stations, which were incorporated into 10 fire stations where addicts can seek help without fear of being arrested, were visited 1,267 times in Nashua and 1,922 times in Manchester.”

One of the most important roles for EMS in the opioid epidemic is to keep addicts alive until they are ready to receive treatment. Helping those addicts find help without fear of arrest is great.

2. Should naloxone recipients be transported? 

Philadelphia officials considered making transport mandatory after naloxone administration.

“The city’s opioid task force considered making ambulance transports mandatory for overdose patients, but the controversial idea did not make the list of recommendations.”

16 percent of overdose patients are refusing transport.

  • Is that high or low, compared to other cities or a national average?
  • What was the mental status and vital signs of the patients who refused transport?
  • How many of those patients get a return visit from EMS or an ED drop off within 24 hours?
  • What’s the 24-hour, 7-day or 30-day mortality for those patients?

Peter Canning wrote about transport refusal after naloxone administration. Canning cited:

A 2017 Clinical Toxicology study Do heroin overdose patients require observation after receiving naloxone? concluded:

Patients revived with naloxone after heroin overdose may be safely released without transport to the hospital if they have normal mentation and vital signs. In the absence of co-intoxicants and further opioid use there is very low risk of death from rebound opioid toxicity.

3. Citizens clear snow to access hydrants

There are many ways for citizens to show their support for public safety – from yard signs to installing CO detectors to learning CPR. One of the easiest ways to show support and make their community safer is by shoveling out fire hydrants. Bravo to the many citizens making their neighborhood safer during the massive winter storm buffeting the east coast. Use department social media accounts to encourage this bit of community service and to recognize the people who accept the challenge.