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Post by LINGERLONGER on May 18, 2017 11:04:54 GMT -5
I don't even care that this is a total drive by post. Thanks for sort of joining the conversation. Can you expand in your thoughts a bit? I can understand your grief. However, are you suggesting that everyone be required to know how to use, and keep on hand, a dose of Narcan? If not, where does it stop? And as a PP said earlier, if we require this, why not an Epi-pen. People die of anaphylaxis all the time. expanding .... This is my sister's passion after losing her son. His outcome would not have changed as he was alone and not discovered for several hours. She (and I agree) is working on getting it into places such as schools, libraries, govt bldgings, and businesses willing to carry it. Training would be required however you can opt out of training with no repercussions, if that makes any sense. If a suspected OD occurs, it CAN be administered, with no liability against the person or institution. If it is not administered, again no liability. An epipen, (IMO) is different. Someone with an allergy usually carries their own. Also there is no epidemic involving anaphylaxis. But....if it is not cost prohibitive, I think it would be good to have one on hand too. Also, you can't count on needle tracks, my nephew snorted it. So here's the thing. AEDs hang on the wall and are good for years (until the internal battery runs out). Narcan is an expensive drug. If I'm a business owner, and I decide there's a likelihood of someone ODing in my establishment, you think I should not only carry this drug, but also learn how to diagnose someone as ODing. That is WAY outside the bounds of what small business owners should do, and seems quite dangerous to me, but putting that aside for a minute.... If I administer Narcan to someone do I then get to charge them, or their insurance company to replace the Narcan? Who carries the burden of the cost?
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Post by LINGERLONGER on May 18, 2017 11:08:42 GMT -5
Didn't mean to post and run. Anything involving this subject it hard for me to talk about still so I had to walk away for a minute. First off, when it comes to schools I think teachers should get training if they want to, but I feel like anyone who wants the training should receive it. However, I think it should be mandatory for school nurses to know, just like I feel like they should be required to learn cpr and how to properly administer an epipen. Part of the job for a school nurse is to be able to respond to a medical emergency until help can arrive and anymore Narcan is something vital to that. As far as liability goes... it is a concern. I just don't think it is a big enough concern that a librarian who wants the training and thinks they could handle it from learning and taking the chance to save someone. Obviously, not every one is cut out for that kind of pressure and that is ok. That is why it shouldn't be mandatory. Also, I think anymore that anyone who works in a building open to the public should be able to recognize the signs of an overdose without checking for track marks. I'm not saying everyone should take a class or anything on it or that it should be required learning but I think that in today's world people should be able to recognize the signs of an overdose so that when they call for help they can accurately describe what is happening to the 911 operator. Like Tipsy said, you can't always count on visible track marks anyway. There are so many ways to get high. I'm going to get a little personal here and admit that the first time I fought addiction I didn't shoot up anything. I was too scared to. So if someone was looking for track marks to find out how to help me I would have been fucked. I feel really, really uncomfortable setting that expectation on a layperson. I think that accurately describing what is happening to a 911 dispatcher and recognizing the signs of an OD are very, very different. I am comfortable telling a medical professional or someone who is acting in that capacity what is going on around me, but I would not expect someone to assess a person's medical situation or needs. YES! I can describe the symptoms of the person to the dispatcher, but it is not my place to diagnose them as ODing, and just say that to a dispatcher. What if I'm wrong? It's better for me to just say the person is not breathing, has a weak pulse, is clammy, and I see some paraphernalia or whatever than to say this person is ODing. The dispatcher will listen to what I tell them, will pass the information align to the EMTs, and they can come prepared for an OD, or whatever else might be happening to that person.
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Post by daub23 on May 18, 2017 11:15:27 GMT -5
I feel really, really uncomfortable setting that expectation on a layperson. I think that accurately describing what is happening to a 911 dispatcher and recognizing the signs of an OD are very, very different. I am comfortable telling a medical professional or someone who is acting in that capacity what is going on around me, but I would not expect someone to assess a person's medical situation or needs. YES! I can describe the symptoms of the person to the dispatcher, but it is not my place to diagnose them as ODing, and just say that to a dispatcher. What if I'm wrong? It's better for me to just say the person is not breathing, has a weak pulse, is clammy, and I see some paraphernalia or whatever than to say this person is ODing. The dispatcher will listen to what I tell them, will pass the information align to the EMTs, and they can come prepared for an OD, or whatever else might be happening to that person. Quoting and bolding for emphasis. Laypeople are NOT medical professionals. I think calling 911 and describing the symptoms and adding "I have access to Narcan and feel comfortable administering it. Should I do that?" is probably the best route in this situation, but man, to expect a untrained person to make that assessment and then administer medication is unfair to that hypothetical person and to the general public.
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Post by daub23 on May 18, 2017 12:01:23 GMT -5
Quoting and bolding for emphasis. Laypeople are NOT medical professionals. I think calling 911 and describing the symptoms and adding "I have access to Narcan and feel comfortable administering it. Should I do that?" is probably the best route in this situation, but man, to expect a untrained person to make that assessment and then administer medication is unfair to that hypothetical person and to the general public. I need to clarify what my sister is advocating for. 911 is STILL called, information is given, no medical assessment. 911 operator can direct you to administer narcan once you rely the situation. You may also have a situation where a medical professional is at the facility, place of business etc. They could administer the narcan that is located on the premises. I am not opposed to increased access to Narcan, training/administration/expectations issues notwithstanding. The issues re: cost, payment if used, expectation around use, etc. that LINGERLONGER brought up do concern me. I'd like to hear your thoughts on that.
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Post by snippet17 on May 18, 2017 12:20:17 GMT -5
I need to clarify what my sister is advocating for. 911 is STILL called, information is given, no medical assessment. 911 operator can direct you to administer narcan once you rely the situation. You may also have a situation where a medical professional is at the facility, place of business etc. They could administer the narcan that is located on the premises. I am not opposed to increased access to Narcan, training/administration/expectations issues notwithstanding. The issues re: cost, payment if used, expectation around use, etc. that LINGERLONGER brought up do concern me. I'd like to hear your thoughts on that. I could never see my FIL's business being able to afford to have Narcan and to train all of his employees. Hell, even with DH's budget I could not see them to be able to fit Narcan and the training for employees in his budget unless the government would increase the amount of money they would give them, which I doubt would happen.
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Post by daub23 on May 18, 2017 12:50:57 GMT -5
I am not opposed to increased access to Narcan, training/administration/expectations issues notwithstanding. The issues re: cost, payment if used, expectation around use, etc. that LINGERLONGER brought up do concern me. I'd like to hear your thoughts on that. Private companies: Not mandatory to participate. Tax credits if you have it on site and offer training to employees, reimbursement from private non-profit organizations and/or govt if used or expired. Expectation is it would be used if situation arises, but no penalties if it is not. No liability to company or its employees and customers Govt institutions and schools: same conditions, etc as having an AED Thanks. I am struggling to see where the funding would come from, at least for the portion to be paid for by the government (I expect it would be a massively unpopular reason to increase taxes/cut funding from other areas, and I think the tax credits offered would probably not be sufficient to fully offset the OOP cost to the business), but I can see getting some funding for non-profits.
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Post by snippet17 on May 18, 2017 12:59:02 GMT -5
I am not opposed to increased access to Narcan, training/administration/expectations issues notwithstanding. The issues re: cost, payment if used, expectation around use, etc. that LINGERLONGER brought up do concern me. I'd like to hear your thoughts on that. Private companies: Not mandatory to participate. Tax credits if you have it on site and offer training to employees, reimbursement from private non-profit organizations and/or govt if used or expired. Expectation is it would be used if situation arises, but no penalties if it is not. No liability to company or its employees and customers Govt institutions and schools: same conditions, etc as having an AED If we cannot get UH I doubt the government would be any help to get Narcan due to the cost increase. am not sure if any non-profits right now do anything even similar to this right now or that someone would have to make one to help fund Narcan in private businesses, schools, etc.
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jdluvr
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Post by jdluvr on May 18, 2017 13:09:17 GMT -5
I don't think private businesses should have to have it unless they want to. I was thinking this was more about public government opperated places like the library, schools, court houses, etc. Our local law enforcement and ambulances are required to have it on hand now because it has become such a problem here.
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Post by chairmanmiao on May 18, 2017 19:33:41 GMT -5
Well, I haven't posted here in roughly 8 years, but here I go.
I think that people generally agreed that this comparison makes zero sense, but I guess that I also don't understand the comparison between Narcan and AEDs. They are like apples and oranges to me. First of all, an AED literally walks you through the steps of using the device safely. You push the power button and it tells you exactly what to do step-by-step and tells you if a shock to the heart is needed. To my knowledge, there is no device that works in conjunction with Narcan that spells out instructions as specifically as an AED. Second of all, opioid overdose is not the only thing that can cause a person to become unresponsive and stop breathing. Diabetic coma and seizures (even without visible jerking motions) can present similarly, too.
The police and all first responders back where I'm originally from have been trained to give Narcan to victims of possible overdose. These people have first aid training anyway and probably have more exposure to what an opioid overdose looks like, so this makes total sense to me. Hell, it's saved a close relative of mine twice now. I agree with whoever said to make such training for lay person (including librarians) voluntary.
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Post by dirrtybutter on May 19, 2017 6:10:46 GMT -5
Right now librarians in my area have the option to take the class that teaches when and how to use Narcan. If you want to learn that's great, but I don't think it should be a requirement. Librarians don't go to school in order to offer medical assistance. They are librarians, not nurses. They should not be required to learn how to use Narcan. I worry about the liability of this too. What happens when someone ODs in a library and no one gets to them in time? Will the family sue the library for not saving their loved one's life? Some people around here are comparing Narcan to having an AED. I see these as completely different things, although I'm not sure I can explain why. I agree with you on all of this. How are people comparing Narcan to having an AED? I do not recall seeing those at some of the public libraries, but it has been a few years since I been to one. I could see people complaining that if a librarian can admissions and give out Narcan that they should be able to do that same thing with EPIpens and other life saving medicines. I see it being a major liability issue, if librarians are trained to use Narcan and have it on stock. Are they going to start requiring other professions to learn how to use it, too, such as high school teachers? Another point to add is the other life saving things that could be snowballed. "Oh you can save the addict but not my son who went into a diabetic coma?" Where does it stop on the "requirements" if it were be a requirement?
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Post by dirrtybutter on May 19, 2017 6:19:41 GMT -5
I was hoping you'd weigh in efmcc67 . It's interesting to hear about the battle to get an AED installed. I have no doubt the focus is on librarians right now because that's where this person happened to OD, but in my state at least, it would quickly expand. So where does it end? Will cashiers be required to learn how to administer it if there is a public restroom in their store? Some people in the comments of the story I was reading said they thought addicts should just die if they OD, and they would not save the addict. Would those people be held liable for not helping? There are too many questions here. This brings up another VERY important point. There are so many horrible shitty humans in this world who truly believe with all their hearts that addicts deserve to die, choose that life, are asking for it and so on. Those people would not want to save someone and honestly would not be able to properly diagnose an OD anyway because they would be clouded by prejudice. It's a disaster waiting to happen if it were a requirement, some asshole sits up on their pedestal preaching about how the addict doesn't deserve the shot and how they feel right in the decision to "let what needs to happen happen".
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Post by LINGERLONGER on May 19, 2017 6:21:30 GMT -5
I agree with you on all of this. How are people comparing Narcan to having an AED? I do not recall seeing those at some of the public libraries, but it has been a few years since I been to one. I could see people complaining that if a librarian can admissions and give out Narcan that they should be able to do that same thing with EPIpens and other life saving medicines. I see it being a major liability issue, if librarians are trained to use Narcan and have it on stock. Are they going to start requiring other professions to learn how to use it, too, such as high school teachers? Another point to add is the other life saving things that could be snowballed. "Oh you can save the addict but not my son who went into a diabetic coma?" Where does it stop on the "requirements" if it were be a requirement? Yep, and lets be honest. There IS a stigma surrounding drug use. A lot of people won't support saving someone they feel brings it on themselves before saving someone who didn't have a choice to go into anaphylaxis, or diabetic shock, or a host of other life threatening issues.
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Post by ven on May 19, 2017 6:23:47 GMT -5
I'm not sure what I can add to this conversation that LINGERLONGER sunshine efmcc67 daub23 and chairmanmiao haven't already said. You guys made excellent points. Making training available (but not mandatory) is great. However, requiring non-medical people to make medical decisions for strangers is a disaster waiting to happen.
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Post by dirrtybutter on May 19, 2017 6:28:23 GMT -5
Are people who are CPR certified required to keep an eye out for anyone who's heart may have stopped? Are people who work around public bathrooms required to keep a ticker of who is in and out of the bathroom? An employees primary responsibility is to ensure that their job is completed properly and safely. Period. If someone VOLUNTEERS to be certified, great, but they shouldn't be reprimanded for not doing so. I think it would be a good idea to put it in CPR certification and keep it with other life-saving equiptment. That said, depending on the size of the library, there should be a % of people who are required to be Life-Saving certified, but not everyone should be. Maybe one to four designated, trained volunteer employees per 25-50 employees who have FT hours? If it's a small library with very few FT employees, then no fucking way. If the library is part of a larger government building (like in my hometown - town hall, tax collector, library, planning, etc. are all one building) then yes, but those people who ARE certified don't necessarily need to be librarians. In schools, the school nurse should be able to do that, and if he/she can't then another designated first-aid-certified person should be able to. Question: Do all teachers need to be first-aid/CPR certified? ALSO, at the risk of possibly sounding like a dick, not everyone is mentally/physically/emotionally equipped to save lives. If you don't want to learn CPR, you really SHOULDN'T get certified. IIRC, if you ARE certified, aren't you required to provide assistance until professionals arrive? Making people perform critical tasks they can't (for whatever reason) can in some instances be just as dangerous as not performing them. This is so true and absolutely does NOT make you a dick. Let's say it's a requirement. You find the person on the ground surrounded by panicked customers/friends/family everyone starts screaming "YOU WORK HERE YOU ARE TRAINED SAVE THEM NOW OMG" but you are terrified, you have social anxiety/some other thing/multiple things and start to confuse exactly what to do, you start to panic over the "what if's" meanwhile the people are shaking you, shouting, demanding you save a life?? What if you have a panic attack, asthma attack, autistic reaction to the stress and so on? Being a first responder is a hard job. They see difficult things and they know they will when they sign up for it. A librarian likes books. I hope everyone knows I'm not saying they are simple people and understand what I mean there. They didn't sign up to be a part time first responder.
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Post by dirrtybutter on May 19, 2017 6:32:37 GMT -5
I think it would be a good idea to put it in CPR certification and keep it with other life-saving equiptment. That said, depending on the size of the library, there should be a % of people who are required to be Life-Saving certified, but not everyone should be. Maybe one to four designated, trained volunteer employees per 25-50 employees who have FT hours? If it's a small library with very few FT employees, then no fucking way. If the library is part of a larger government building (like in my hometown - town hall, tax collector, library, planning, etc. are all one building) then yes, but those people who ARE certified don't necessarily need to be librarians. This bring us back to the epi-pen question. Should those also be kept on hand wherever you go? Should librarians also be asked to learn how to administer those? Maybe a better way to handle it would be to have addicts carry Narcan on them in the same way we have people with allergies carrying epi-pens. But then addicts are notoriously unreliable, so do we want to risk putting that in their hands? AND, not to mention the cost. Epi pens are expensive. Now if it's a requirement for libraries, how long before it becomes a requirement at all large business? Now they have to write their budgets with concern to large, expensive, life saving materials, AND training for all employees to use them? Are some employees religious exempted?
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Post by dirrtybutter on May 19, 2017 6:36:04 GMT -5
Ohhh this is such a good point. The idea of putting a person with no medical training in the position of evaluating someone medically, and the implications of that, is actually kind of frightening. Yes. On the flip side, I had a friend in library school who had some major medical issues, that the doctors couldn't diagnose. All of the testing gave her serious track marks. For her, collapsing in public was a very real possibility, no drugs involved, but an amateur could easily have mistaken her for an addict and administered care accordingly. Since Narcan is non-toxic to people who didn't OD, this isn't the very worst thing, but could delay the care she actually needed. Another excellent point. Hell, I have needle marks and was quite bruised up from all the blood tests I've had just from being pregnant!
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Post by LINGERLONGER on May 19, 2017 6:38:13 GMT -5
This bring us back to the epi-pen question. Should those also be kept on hand wherever you go? Should librarians also be asked to learn how to administer those? Maybe a better way to handle it would be to have addicts carry Narcan on them in the same way we have people with allergies carrying epi-pens. But then addicts are notoriously unreliable, so do we want to risk putting that in their hands? AND, not to mention the cost. Epi pens are expensive. Now if it's a requirement for libraries, how long before it becomes a requirement at all large business? Now they have to write their budgets with concern to large, expensive, life saving materials, AND training for all employees to use them? Are some employees religious exempted? And what if someone says their religion doesn't allow them to provide these services, for whatever reason. Does that mean that now these places will have to have 2 people on the clock when that person is working just in case? These costs are ballooning in this thread alone. Now you! Go respond to my other thread
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Post by dirrtybutter on May 19, 2017 6:41:46 GMT -5
I need to clarify what my sister is advocating for. 911 is STILL called, information is given, no medical assessment. 911 operator can direct you to administer narcan once you rely the situation. You may also have a situation where a medical professional is at the facility, place of business etc. They could administer the narcan that is located on the premises. I am not opposed to increased access to Narcan, training/administration/expectations issues notwithstanding. The issues re: cost, payment if used, expectation around use, etc. that LINGERLONGER brought up do concern me. I'd like to hear your thoughts on that. Going with Frenchie's plan here, say the person calls 911 and says all that stuff and the 911 operator advises to give the shot. Something goes wrong. Who is liable? What if the caller is "over eager" to "save" addicts (which is a thing) and jumps the gun but makes a mistake?
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Post by dirrtybutter on May 19, 2017 6:44:57 GMT -5
Another point to add is the other life saving things that could be snowballed. "Oh you can save the addict but not my son who went into a diabetic coma?" Where does it stop on the "requirements" if it were be a requirement? Yep, and lets be honest. There IS a stigma surrounding drug use. A lot of people won't support saving someone they feel brings it on themselves before saving someone who didn't have a choice to go into anaphylaxis, or diabetic shock, or a host of other life threatening issues. AND how would this hypothetical person know the difference between all those conditions?? A vial of insulin looks like drugs to some people!
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Post by daub23 on May 19, 2017 7:05:47 GMT -5
I am not opposed to increased access to Narcan, training/administration/expectations issues notwithstanding. The issues re: cost, payment if used, expectation around use, etc. that LINGERLONGER brought up do concern me. I'd like to hear your thoughts on that. Going with Frenchie's plan here, say the person calls 911 and says all that stuff and the 911 operator advises to give the shot. Something goes wrong. Who is liable? What if the caller is "over eager" to "save" addicts (which is a thing) and jumps the gun but makes a mistake? I agree, especially in states that do not have Good Samaritan laws that directly address Narcan administration.
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