Thursday, October 01, 2020

The Case For Narcan | Part 2: The How

In my last post I talked about why you should carry Narcan. In this post, I'm going to talk a bit about how I do it.

First off, I updated the first aid cheat sheet that is accessible on my phone's home screen to include instructions for dealing with an opioid overdose.

  • Check responsiveness: try verbal, sternum rub, ear pinch
  • If unresponsive, call 911, retrieve AED
  • If possible opioid overdose:
    • Open airway: Tilt the casualty's head gently and lift the chin up with 2 fingers. Pinch the person's nose
    • Give 2 breaths
    • Give Narcan: insert into nostril until finger touches base of nose. Press plunger.
    • Give rescue breaths for 3 minutes
  • Check breathing
  • If breathing: maintain airway
  • If not breathing:
    • 30 compressions (2 hands for adult, 1 for child, 2 fingers for baby)
    • Open airway: Tilt the casualty's head gently and lift the chin up with 2 fingers. Pinch the person's nose
    • Give 2 breaths
  • Utilize AED as soon as available
  • Recovery Position
    • Kneel beside victim
    • Place victim's closest arm above the head, and furthest arm across the chest
    • Bend the victim's nearest leg at the knee
    • Place your hand under the hollow of the victim's neck to stablize the head
    • Roll the patient towards you so the head rests on the extended arm and the face is facing slightly downward
    • Bend both legs at the knees to stabilize victim

Next, I updated the first aid gear I carry in my man-bag. It's now split into three parts:

On the left, you have the bleeding kit. It contains a SWAT-T tourniquet, gloves and a 1 meter square sheet of orange parachute material. The fabric is intended as a signal panel, though it can be used as an improvised triangular bandage.

There's a bit of controversy around the SWAT-T tourniquet as it's not TCCC approved, is hard to self deploy and arguably requires more dexterity in general to deploy than a windlass tourniquet. On the other hand, the wide nature of the SWAT-T means that it's effective, it works reliably well on children and even dogs and is effective with minimal training. It's also a multi-purpose item and stores smaller than the CAT tourniquet that is the gold standard in the military. For now, I'll stick with the SWAT-T.

The general purpose kit in the middle contains varieties of tape, band-aids, medications and a few odds and ends like ear plugs and floss.

Finally, there is the unresponsive kit which contain gloves, a face shield, Narcan and a quick reference card.

The setup fits into three small plastic bags, each of which can be accessed individually for a slightly faster response.

While I hope the above is useful, I also wouldn't over think it. Dropping a dose of Narcan in your purse, backpack or briefcase and keeping one in your medicine cabinate is doing a significant community sevice. The opioid epidemic is heartbreaking, but you can be part of the solution. E-mail narcan@alringtonva.us to learn how you can get trained and armed with this life saving drug.

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