EMS World

DEC 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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52 DECEMBER 2018 | EMSWORLD.com T he increase in opiate overdoses is convincing many businesses and individuals to have Narcan (nal- oxone) readily available. Simply spraying Narcan directly into a victim's nostrils allows anyone to save a life in sec- onds, making the drug a natural addition to any first aid kit. It seems logical that it be included with any medical supplies meant to serve the public—including those on com- mercial airliners. Paramedics Jared Oscarson and Pat Songer likely assumed this to be the case in October. The men were flying on Delta from New Orleans to Atlanta when a medical emergency arose. Senior vice presidents of business relations and operations, respec- tively, for the New Orleans-based mobile health service Ready Responders, Oscar- son and Songer discovered otherwise when the emergency occurred—and Narcan was nowhere to be found. The Incident The emergency began innocently enough. "Probably 15 minutes after a normal take- off, a flight attendant came across the intercom and asked if any medical person- nel were aboard the plane," recalls Songer. "I looked up and said, 'I'm a paramedic.' and she took me and Jared back a few rows to look at a male who was apparently uncon- scious, with his head lolling forward." As the flight crew retrieved the airplane's medical kit, Oscarson and Songer repo- sitioned the unconscious man's head to restore respiration and began evaluating his medical condition. "He was cool to the touch and displaying respiratory depres- sion," says Oscarson. "His eyes had pinpoint pupils." Using a glucometer they borrowed from a passenger—the first-aid kit didn't have one—the paramedics found the patient's blood sugar levels were within acceptable limits. This eliminated their first differential, which was that the patient was hypogly- cemic. "The concerning part for us was that he had pinpoint pupils, which meant he was now fitting the clinical pathway for an opi- ate-type ingestion," Oscarson says. "This was not a medical problem that was diffi- cult to manage, except that they didn't have Narcan on the airplane. We had a full ALS kit, and we could have done everything but give Narcan. I mean, we had atropine and epi—just about every drug you can imagine. Just not Narcan." Lacking it, the two paramedics did what they could to keep the patient stable until the flight landed in Atlanta. Once on the ground, local firefighters boarded the plane, consulted with Oscarson and Songer, and administered intranasal Narcan. "This roused the patient immediately and raised his respiration rate," says Oscarson. NARCAN MISSING FROM AIRLINES' MED KITS By James Careless A patient's apparent overdose highlights a glaring omission

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