The man was unresponsive, his breathing shallow. The Marin County, CA, police officer first at the scene located a pulse while the man’s companion reported that he had been using heroin.
The officer performed a sternum rub with no response. The man’s eyes were slightly open, though, and he could see that his pupils were pinpoint, almost not visible. Assuming heroin overdose, the officer removed naloxone from his AED bag and administered one 4 mg dose in the man’s left nostril. He continued to monitor the man, confirming that he still had a pulse, until EMS arrived a minute later. The man then responded to a sternum rub by EMS by blinking his eyes and gasping shallowly.
This report represents the sentinel Narcan administration in the county by law enforcement under a new program that stocks naloxone and trains police in its use. We were concerned about the potential for unintended consequences when we first heard about such programs.
What if the patient wakes up and becomes combative with law enforcement? What if professional addicts flee the scene or otherwise refuse EMS evaluation? What if such programs serve only to enable users, discouraging them from seeking addiction treatment? We turned to the comfort of our old friend, the warm and reassuring embrace of evidence-based literature, to assess the validity of our worries.
Read more at:
Ballard, Dustin MD; Vinson, David MD
Emergency Medicine News: March 2018 – Volume 40 – Issue 3