This show is brought to you by Primary Arms







http://frn.deals/pa









https://www.primaryarms.com/expo-arms-uppers









Into LIndsey “ The PreHosptialist”







Narcan - recap what narcan is







“Myth” of narcan-induced combativeness: anecdotal topic







How EMS providers are often the root cause of post-narcan agitation







Goal is to titrate narcan to adequate respirations, but in a world where everyone has 2-8mg narcan, EMS often arrives to a waking patient







Ways to not suck so bad:







Avoid swarming patients as they start to arouseAvoid immediately asking “what did you take?”Avoid offensiveness when patients deny drug useAvoid prophylactic restraints in anticipation of combativenessAvoid judgemental words, tone, nonverbalsRemember dogs, children and patients all have the following in common: they feed off our energy and mimic it







Other causes of agitation: hypoxia, hypercapnia







**ventilation/oxygenation prior to waking = happier awake patient**







Dosing extremes:







Some places: volume so high, not realistic to titrate and transport every OD







Other places: 0.04 mg IV titrated to respirations







Leaving patients after waking from Narcan: low-risk







“Numerous studies have evaluated the safety of patient refusal after naloxone resuscitation and have found extremely low mortality rates, ranging from 0-0.48% in the 24-28 hours after refusal [1-7]. In these studies, patients who passed the EMS system’s refusal criteria were allowed to decline transport to the hospital.”







Pulmonary edema super rare







Support:







Leaving narcan with patient







Addiction resources







Suboxone