The writing style is appropriate for the audience and gets to the point. The case studies-all trauma cases-draw the reader into a hypothetical ambulance call: The time of the call is 1: After this, the author explains what happens between the time of arrival on scene and when the crew first encounters the patient.
New York City nasal naloxone device: New commercially available Nasal Naloxone IN Krieter et al present initial pharmacokinetic data regarding the newly available prepackaged IN naloxone product marketed by Aptar. Bottom line is that IN naloxone 4 mg results in higher plasma concentrations of drug than the intramuscular dose 0.
If this product is priced at an affordable cost, I predict it will displace all other forms and could become a huge commercial success going home with everyone on long term opiates. However, given recent obvious greed and over-pricing of life saving home medications such as Epi Pens, I will believe this when I see it.
BLS provider administration of IN naloxone Multiple states and city's allow IN naloxone delivery by lay persons so it makes sense that they allow their BLS providers to also administer this potentially lifesaving medication.
Click here for a slide presentation on the topic. Click here for slide presentation for Boston BLS data.
Coffin and Sullivan used all the above data along with many other studies related to home use of injectable naloxone and did a cost analysis of the utility and expense related to home naloxone therapy. They hypothesize similar cost effectiveness for use of naloxone to reverse accidental overdose from prescription opiates which is now the leading cause of death in young adults in the United States.
In an accompanying editorial, Compton et al  review the FDA views on the topic — which are extremely favorable towards prescription home naloxone and eventually over the counter naloxone. At this point the FDA is fully aware of the off-label lay person use of naloxone both nasally and Intramuscularly and applauds this movement but hopes to encourage the pharmaceutical industry to develop easily administered and more highly controlled forms of this medication.
I doubt this is a very hard decision and I find it amazing and sad when I hear some clinicians or politicians comment on the ethics of distributing naloxone Paramedic case studies online lay people and their concern that it will increase risk taking.
T hey are spouting uninformed rumors rather than evidence. Even were they correct, are we to infer that these patients are disposable humans not worth this trivial cost? They should read some of the articles reviewed on this page that actually show REDUCED risky behavior in the cohort of injection users who are trained to use rescue naloxone - this knowledge elevates them within their peer community and gives them an increased sense of worth that frequently leads to reductions in opioid use.
In Fisher et al published data demonstrating that non-medical first responders police are fully capable or delivering IN naloxone to appropriate candidates. Only one case out of patients led to combativeness — also confirming the low incidence of agitation following IN naloxone delivery.
Gulec et al analyzed appropriateness and effectiveness of naloxone delivery by BLS versus ALS providers over a two year period. They had cases to analyze and found no differences between the two groups. They conclude that intranasal naloxone delivered by BLS is as effective and given as appropriately as any naloxone given by ALS.
They recommend the the National EMS scope of practice guidelines include BLS administration of nasal naloxone for suspected opioid overdoses. This data is important because it shows that if left alone without ALS intervention, generic nasal naloxone which is probably a bit dilute is effective in the same percentage of patients as the more expensive highly concentrated formulations.
The point being — if your budget is limited this therapy may be more cost effective than trade name IN Narcan and just as clinically effective. Conclusions regarding layperson and BLS administered naloxone The evidence increasingly supports the effectiveness and safety of layperson administered naloxone.
Furthermore, the USA is in the throngs of a major epidemic of opiate overdose deaths from prescription pain medications with some states death rates exceeding that of motor vehicle crashes, homicides, and many other causes of death in young adults.
Hopefully we will see the FDA make this a non-prescription therapy in the very near future. Paramedic use of intra-nasal naloxone The Denver Health Paramedic system investigated the efficacy and safety of atomized intranasal naloxone for the treatment of suspected opiate overdose.
After intranasal naloxone, standard protocols were followed including airway management, IV placement, and administration of IV naloxone.
Ninety-five patients were enrolled. Fifty-two patients responded to naloxone: Four of these "non-responders" had IV naloxone so rapidly less than 3 minutes that it is likely the nasal naloxone did not have time to produce a clinical effect.
An additional four of the nine "non-responders" had anatomic abnormalities that may have prevented intranasal medication absorption epistaxis, nasal trauma, nasal septal abnormalities.
The median times from arrival at patient side to awakening and from administration of the IN naloxone to patient awakening were 8. These median times to awakening after arrival and naloxone administration are less than those reported by Wanger et al for intravenous naloxone 9. Kelly et al conducted a similar EMS study, comparing intranasal naloxone to intramuscular naloxone in prehospital opiate overdose cases.
This finding was felt to be an advantage of IN naloxone, since the rapid awakening and hypoxic agitation seen with administration of IV naloxone is of considerable concern to some EMS providers.
Based on this data and the considerable danger of needle stick exposure in this patient population, these authors conclude that IN naloxone should be the first line therapy for opiate overdose in the prehospital setting. Robertson et al reviewed their EMS data on opiate overdoses requiring rescue naloxone over a 17 month period.
The mean time from arrival at scene to awakening was identical for both delivery routes about 20 minutes though naloxone was faster in onset once an IV was established 8 minutes versus 12 minutes.
Using this strict inclusion criteria they found 96 cases of opiate overdose treated with naloxone. Of these cases 55 received IV naloxone, 38 intranasal and 3 intramuscular. Comparing baseline respiratory rates and change in Glasgow coma scores they found no statistical difference: The authors conclude that "among subjects with confirmed opioid overdose, intranasal naloxone is as effective as intravenous naloxone at reversing central nervous system depressive effects caused by opioids.About the Paramedic Program.
Paramedic (MICT) Program Overview; Class Descriptions; Program Locations; Example of Case Study. Much Ado About Stools Giardiasis Strikes Middle America. Clinical Case Study #1. studies have shown that G. lamblia interferes with the absorption of fats, but few other nutrients.
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Heat Stroke Case Study. Never Run Into Any Situation as a Paramedic. Scene Safety and Narcotic Overdoses.
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Gastric Banding Emergencies. Look For A Pulmonary Embolism. Mental Illness, or Just Bad People? Trauma Case Studies For The Paramedic 1st Edition by American Academy of Orthopaedic Surgeons (AAOS),, Rahm, Step () Paperback by American Academy of Orthopaedic Surgeons (AAOS) Paperback.
Being a paramedic practitioner is a highly rewarding and stimulating career, with many opportunities to specialise. Following a curriculum that is informed by service users and carers, and focuses on quality patient management, you'll work in the unpredictable environment of pre-hospital healthcare and, as such, you will learn how to be dynamic with your decision-making, aptitude and.
Case Study Of Meningococcal disease - Essay. Print Reference this. Published: 23rd March, Last Edited: 11th April, Disclaimer: This essay has been submitted by a student. This is not an example of the work written by our professional essay writers. As a paramedic attending a patient it is important that all presenting.