Headline: "Crews halt fentanyl OD"

[my5cents]

http://www.castanet.net/edition/news-st ... htm#181407

Likely lots saw this headline introducing a story explaining that Penticton Fire now have naloxone kits and the training to use same. As the story goes on it states :

"Firefighters and BC Ambulance personnel responded to the overdoes just after 11 a.m. Saturday morning. Crews were able to use the naloxone kit to halt the overdose and return the patient back to consciousness."

How many got the impression that before this first administration of naloxone, emergency responders in Penticton did not use naloxone ?

So it would likely be a surprise to some readers that the BC Ambulance paramedics have used naloxone in Penticton for many years.

I guess it makes sense to make the drug available to the fire department, since even drug addicts have been given access to naloxone and the training on how to use it.

Perhaps it was a slow news day.

[twobits]

Probably was a slow news day but it is good that the Fire Dept is now receiving the kits and the training. Because of the resources that the Fire Dept has available to respond, they can always be first on scene vs. the capacity and call out time for ambulance. In my experience any way, Fire is always at a scene long before an ambulance arrives.

[my5cents]

Probably was a slow news day but it is good that the Fire Dept is now receiving the kits and the training. Because of the resources that the Fire Dept has available to respond, they can always be first on scene vs. the capacity and call out time for ambulance. In my experience any way, Fire is always at a scene long before an ambulance arrives.

I wouldn't say always, but yes, many times they can arrive first. The quality of treatment another question ?

[ToddT]

If I'm dying, the quality of treatment isn't as important if it means I'm living.

[my5cents]

If I'm dying, the quality of treatment isn't as important if it means I'm living.

What I'm saying is that the two aren't even close to the same.

If my house is on fire, I need a fire truck and fire fighters.

If I am in cardiac arrest I need trained paramedics not fire fighters with basic knowledge of first aid. Yes if fire gets there first there might be something they can do, but I'd be counting on the Ambulance Paramedics.

[twobits]

What I'm saying is that the two aren't even close to the same.

If my house is on fire, I need a fire truck and fire fighters.

Of course you do. But if your house is on fire are you going to tell the neighbors to put away the garden hose until the pro's arrive?

If I am in cardiac arrest I need trained paramedics not fire fighters with basic knowledge of first aid. Yes if fire gets there first there might be something they can do, but I'd be counting on the Ambulance Paramedics.

Don't disagree with you but I have to side with Tod. If I'm on the pavement in cardiac arrest or a drug overdose, I'd be happy if a RN stopped to help before the big guns could arrive. My logic is simply that it is a good thing for the Fire Dept that is typically there first has the ability to perform more than basic CPR. It is the same logic as the Community Center swimming pool now having a defib unit and staff trained to use it. Two people that I am aware of are alive today because of it.
Things like mobile defibs and opiate kits should be viewed as front line resources that can save lives, not a replacement for paramedics or the Fire Dept.

[my5cents]

Don't disagree with you but I have to side with Tod. If I'm on the pavement in cardiac arrest or a drug overdose, I'd be happy if a RN stopped to help before the big guns could arrive. My logic is simply that it is a good thing for the Fire Dept that is typically there first has the ability to perform more than basic CPR. It is the same logic as the Community Center swimming pool now having a defib unit and staff trained to use it. Two people that I am aware of are alive today because of it.
Things like mobile defibs and opiate kits should be viewed as front line resources that can save lives, not a replacement for paramedics or the Fire Dept.

Well the topic is the administration of naloxone, not if community centres should have defibrillators. I have a close friend who dropped dead on the ice at an old timers hockey game and is alive and healthy because his team took it upon themselves to have one.

The topic was started because of the headline that it was news that the Penticton Fire department had naloxone kits, and the contents of the article was so vague that one could falsely believe that "now Penticton had naloxone for emergency crews", when in fact the BC Ambulance Service has had it for years and years.

I guess my worry, is more in depth. The more we say "well, the fire can do that..." ,,,, "well maybe all we need is less ambulances, fire can do that".

We could be at risk for letting the government (who would love to) degrade their already waning support for the BC Ambulance Service. Created by the "enemy" the NDP in the early 70's.

A quality, life saving, paramedic program is expensive. Fire departments already exist and thus are "free" and they get there fast ! (We'll forget that the fire departments "desire" to attend car accidents, medical calls, etc is more targeted to the fire department being able to pad their call stats than in many cases, contribute at the scene of a non fire emergency)

There is a very simplistic view that first aid is first aid and the first and all important criteria is who arrives first.

What if you were in diabetic shock, fire arrive, don't do all the preliminary tests that ambulance do (and NO they do not, it is NOT part of their protocol) and they administer naloxone ? Not going to do much for your problem is it ?

To ToddT : "Quality of Care" wasn't referring to a great bed side manner, or a sharp looking uniform. It means treatment that helps the situation and preps the patient for further emergency room treatment, ie and IV started (if needed), correct and full vital signs, the major items addressed, airway, breathing, circulation, etc etc

[ToddT]

To ToddT : "Quality of Care" wasn't referring to a great bed side manner, or a sharp looking uniform. It means treatment that helps the situation and preps the patient for further emergency room treatment, ie and IV started (if needed), correct and full vital signs, the major items addressed, airway, breathing, circulation, etc etc

I throw politics out the window when it comes to saving someone's life. If you can't do that you might be in the wrong profession. I'm happy the Firemen have the resource, and I'm happy we have Paramedics too.

[Drip_Torch]

I can see both sides to this argument.

Think there is an issue around balance that my5 is alluding to, but I also agree with Todd.

Closest available resource - I'll take it, but I wouldn't want to see the Provincial Ambulance service delivery model swayed too much by the mindset there's firefighters there to pick up the slack. Different jobs, different training, different equipment.

[twobits]

Closest available resource - I'll take it, but I wouldn't want to see the Provincial Ambulance service delivery model swayed too much by the mindset there's firefighters there to pick up the slack. Different jobs, different training, different equipment.

Agree, but I have think that 20 buck Nalox kits are not going to jeopardize ambulance funding if supplied with training to Fire Dept first responders. Kits available to as many as possible qualified is a more efficient use of resources we already have attending. And given the huge spike in OD's the more available is obviously better. The corollary to this is that our ambulance paramedics are not tied up dealing with these now frequent OD's and can devote their specialized training to situations that are not just Nalox injections. That in turn is going to speed up their response time to situations that Fire responders are less qualified to deal with.
I guess I kind of look at the same way as the evolution to Nurse Practitioners in the delivery of basic front line medicine like stitching a cut or antibiotic prescription for an infection. It just makes sense and free's up the bigger guns to do what they are most valuable for.

[Drip_Torch]

100%

Just saying I can see the broader narrative contained in My5's post. (Provincial download onto Local Government) I know my old department is currently struggling to stay within the volunteer (paid on-call) service delivery model. Due mainly to the volume of first responder calls.

Things have change quite rapidly in the fire service over the years, and I sometimes wonder if the decision makers are at all aware of how the service model changes have evolved? I remember when tow trucks were the tool for performing auto extrications, and occasionally fire would get a call out for wash down - long after the fact. (and that was in one of the more progressive jurisdictions in BC)

Locally, glad to see fire carrying the naloxone, reads like it didn't happen a moment too soon.

[my5cents]

Agree, but I have think that 20 buck Nalox kits are not going to jeopardize ambulance funding if supplied with training to Fire Dept first responders. Kits available to as many as possible qualified is a more efficient use of resources we already have attending. And given the huge spike in OD's the more available is obviously better. The corollary to this is that our ambulance paramedics are not tied up dealing with these now frequent OD's and can devote their specialized training to situations that are not just Nalox injections. That in turn is going to speed up their response time to situations that Fire responders are less qualified to deal with.
I guess I kind of look at the same way as the evolution to Nurse Practitioners in the delivery of basic front line medicine like stitching a cut or antibiotic prescription for an infection. It just makes sense and free's up the bigger guns to do what they are most valuable for.

It has NOTHING to do with the value of a naloxone kit. Just like Drip Torch correctly states, I'm afraid of a download. First element is getting the press to buy in to the idea and it goes from there.

There are a lot of people who think ambulances are horizontal taxis, nothing more. The "professionals" are the fire fighters.

They are "so good" they come to all the traffic accidents and help out. They are always there for us......

Actually they are at the station watching TV and cooking so much they need the stats to justify their existence. So they attend calls they shouldn't be at, at all.

If you had a friend in the ambulance service or police you might form a different opinion of the fire department.

It's great they have the naloxone, that really isn't the point. The point was that the reporter made it sound like when the fire department got the naloxone, it was at the same time the ambulance got it. They are giving the naloxone out to just about anyone who can figure which end gets jabbed into the patient.

The BC government (Liberal Govt) is the enemy of the BC Ambulance Service. If the truth were known I think the government would love to have fire department ambulances throughout and trash the entire Ambulance Service.

The public could probably be lead that way because "everybody loves a fire fighter". That is except those that have to work around them like police and ambulance attendants. They know they roar out to most scenes to get a stat and can't wait to get a badge number so they can leave and get back to bed, watching TV or cooking/eating dinner.

[ToddT]

It's beginning to sound to me like someone has some serious sour grapes. I respect Police, Fire and the Ambulance Service equally. Nurses are another thankless profession. No matter what you do in life there will always be some bad apples, but to point your finger at an entire department of people who risk their lives to save ours is both classless and ignorant.

I have never once thought of an Ambulance as a taxi, and it boggles my mind that anybody would think that.

You are no better than them as they are no better than you is my motto.

[fluffy]

I guess my worry, is more in depth. The more we say "well, the fire can do that..." ,,,, "well maybe all we need is less ambulances, fire can do that".

Has there ever been a case where paramedic duties were handed off to the Fire Department, or is this merely a case of common sense, in having the naloxone kits distributed wider than just paramedics ? I see this as a response to the meteoric rise in opioid overdoses, and the possibility that we may have a number of emergencies occurring concurrently.

[my5cents]

It's beginning to sound to me like someone has some serious sour grapes. I respect Police, Fire and the Ambulance Service equally. Nurses are another thankless profession. No matter what you do in life there will always be some bad apples, but to point your finger at an entire department of people who risk their lives to save ours is both classless and ignorant.

I have never once thought of an Ambulance as a taxi, and it boggles my mind that anybody would think that.

You are no better than them as they are no better than you is my motto.

I'm not going to get into a flame war.

The term "sour grapes" is probably not the best phrase to use, but for discussion sake, I gather you are inferring that I am unjustly negative towards fire fighters. You go on to say "there will always be bad apples". Indicating perhaps my negativism is directed at fire fighters because of a bad experience with an isolated one or two.

Actually I know several fire fighters, in fact have a nephew who is a fire fighter. I don't think I've ever had a problem with a fire fighter individually.

The nature of fire fighting is the problem between fire fighting organizations and their employers, generally municipal governments. The problem being until there is a fire, what do they do. How do they justify the expensive equipment, the wages etc. All fire departments like any other organization justify their budgets with statistics.

What if a fire department didn't answer a fire call for several days, how would that look ? Solution, attend other emergencies and "help out". That two day period where no crews from that department attended a fire, can now say they went out on X calls, assisted with this assisted with that.

In some cases their help is needed and appreciated, but in many they are not required and at times are a detriment. Ask the police investigator trying to piece the circumstances of a motor vehicle accident together when the debris (evidence) has been swept up into a nice neat pile by a fire fighter trying to be helpful.

There is no harder, dangerous job than being a fire fighter when they are fighting a fire.

So your statement "but to point your finger at an entire department of people", your contention is completely correct, I'm pointing at the entire department, in fact most fire departments, NOT individual fire fighters. They don't set the policy that sends them out. There are some departments that don't automatically attend, but are there in a flash when requested, but the vast majority automatically attend, roaring around so they (the department) can amass statistics.

This willingness by fire departments to be "everything to everybody" allows the BC Govt to underfund and understaff the ambulance service. I suggest not caring that the quality of care to the patient can suffer.

It's not that firefighter are not "as good" they just have different training. Their training is directed more towards putting out fires, hazardous chemicals, physically rescuing people. There are different levels of ambulance paramedics and correspondingly more or less training. But even that standard paramedic, with the training, their experience and on-going training, would be far too much to consider adding to the knowledge required to be a firefighter.

To the man on the street, "someone showed up, with siren and red lights and helped" that's all they know.

I'm glad you haven't thought of an ambulance as a horizontal taxi, but unfortunately many aren't aware of what they really do. I've heard people say, "well the fire department had to attend, because the guy needed oxygen" (not knowing the ambulance service has vastly more equipment for the treatment of patients than fire has).

I guess some of the reason for those misconceptions come from the US where in many locations the fire departments do the jobs our ambulances do.

Many many years ago, in some jurisdictions the ambulances were run by funeral parlors. I don't know if I like the thought of that. A white Cadillac for an ambulance and a black one for a hearse. If they did a poor job treating you and taking you to the hospital in the white Cadillac you left the hospital in a black Cadillac