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Light Weights – Heroin Math 2 (Why We Don’t Get Robbed of our Fentanyl)

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You carry four 100 mcgs vials of Fentanyl in your controlled substances kit.  How much would those vials be worth on the street? Let’s do the math. 100 mcgs of Fentanyl is the equivalent of 10 mgs of Morphine. Morphine is 50% as strong as heroin. Morphine is the equivalent of 50% pure heroin. A […]

An Offer Hard to Refuse: Heroin Math 1 (Pills to Mainlining)

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Thesis: People addicted to prescription painkillers who buy their pills on the black market switch to heroin because it is a better economic deal (cheaper and stronger). The Situation: When a person’s painkiller prescription runs out or their tolerance outruns their prescription, and the user still needs opioids to keep from being sick, the user […]

Fact or Fiction

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Great article on ems1.com Medical commentary on the issue of danger to first responders of transdermal fentanyl exposure. Dr. Tan, discussing transdermal fentanyl exposure, agrees that exposure as would be typically encountered by first responders is an extremely low risk. “It is not zero risk and certainly not impossible, but extremely low,” he said. Fact or […]

A Mother and Son

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The woman with the cellphone stands outside the car. She explains that the male in the car has been smoking crack, taking benzos and doing heroin for several days. I ask if he is breathing. She says yes, but he is asleep right now. When she picked him at his friend’s house in their suburban town […]

Fentanyl Skin Exposure: An MD’s View

A story published in Slate magazine yesterday questions the assumptions behind the widely reported episode of the Ohio police officer who required four doses of Naloxone after brushing Fentanyl off his shirt. The Viral Story About the Cop Who Overdosed by Touching Fentanyl Is Nonsense Written by Jeremy Samuel Faust, an emergency physician at Boston’s Brigham […]

Fentanyl: A Briefing Guide for First Responders

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Carfentanil (which had previously been seen in neighboring states) has now been officially identified in Connecticut.  The discovery of this drug 100 times stronger than Fentanyl poses questions: How much danger does Carfentanil (or Fentanyl for that matter) pose to EMS?  How can we in EMS protect ourselves from exposure to these drugs? What should […]

EMS Stroke Care

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Stroke Care should follow your local medical direction and treatment guidelines.  Here’s how we do it in North Central Connecticut. EMS Role When Emergency Medical Services (EMS) recognizes stroke in the field, and notifies the hospital either by radio patch or transmission, the hospital stroke team can be activated prior to the patient’s arrival. With […]

High Risk

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The dispatch is for an unresponsive overdose, likely fatality.  We are coming from a fair distance, but we are the only unit available.  There no updates.  No PD dispatcher asking if we are a medic unit or the message that CPR is in progress.  PD and fire have beaten us to the scene, but as […]

Narrative

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  Upon arrival found a 22 Y/O female unresponsive lying on the floor of her bedroom with her father performing CPR on her. He states that he last saw her alive a hour ago and then found her on the floor unconscious before calling 911. He states she has a history of heroin abuse and there is a used […]

Narcan 4mg IN

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I was a big initial fan of the intranasal atomizers both for pain management and opiate overdoses.  I liked them for pain management for their quick access.  I often gave an intranasal dose, and then after getting an IV, gave the rest IV.  Overtime I noticed quite a difference in response between the two methods. […]

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