Welcome to Episode 72

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Link of the Week: A Study of First Responders and Pandemic Response

A number of studies have been done asking if first-responders (EMS/firefighters/hospital workers) will come to work or remain on duty during a pandemic. Distribution of this survey will be a collaborative effort among several bloggers and podcasters.

You may find links to this survey on numerous sites. In order to maintain accuracy, we ask that the survey be completed once per person.

Effects of Pandemic Situation on First Responder Staffing

Find the survey here:

Pandemic Survey



Giving Back by Teaching

9/11 Rescuer Benefits Still Lacking

Ambulance Fire Injures Paramedic

Men Avoid Routine Dr. Visits


Tip/Trick of the Week — Combitube

NREMT Skill Sheet Download (pdf)

Combitube How-to Study


Med of the Week — Narcan (naloxone)

Drugs.com on Narcan


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This week

“Breath Deep” by Caitlyn Smith

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Caitlyn Smith


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Until next time, Scene safety, BSI!

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One Response to Combitube, Narcan, and Episode 72

  1. Eric says:

    Jamie – You said “There are no significant adverse effects for narcan.” I know, from first-hand experience, that there are. Here goes:

    From http://www.merck.com/mmpe/lexicomp/naloxone.html

    ‘Due to an association between naloxone and acute pulmonary edema, use with caution in patients with cardiovascular disease or in patients receiving medications with potential adverse cardiovascular effects (eg, hypotension, pulmonary edema or arrhythmias).’

    From http://www.pbs.gov.au/pi/cspnalox10606.pdf

    ‘Use with caution in patients (including the elderly) with pre-existing cardiovascular disease and in those receiving medications with potentional adverse cardiovascular effects, such as hypothension, ventricular taccycardia or fibrillation, and pulmonary edema. Serious adverse cardiovascular effects, such as VT, VF, acute pulmonary edema, hypotension & cardiac arrest have been reported… It has been suggested that the pathogenesis of pulmonary edema associated with the use of naloxone is similar to neurogenic pulmonary edema, i.e. a centrally mediated massive catecholamine response leading to a dramatic shift of blood volume into the pulmonary vascular bed, resulting in increased hydrostatic pressures.’

    And from that first hand experience, my former trainee’s blog about that fateful day:


    She describes what we had in a much better way than I.

    I revert back to my internship, where a full 2mg of Narcan submentally (yes, submentally) injected was the norm, and push the remaining meds. My patient crumps. So much for Narcan being a relatively innocuous drug…
    I do not push Narcan lightly now, particularly if the patient has an underlying pulmonary condition…
    I spent much time afterwards fondling various suction catheters, blades, and laryngoscopes, staring at the vent, going over in my head dosages, techniques, indications and contraindications. I read everything I could about naloxone, chronic pain, and types of pneumonia.

    Anyway, I thought I’d share this information, because I, too, thought that Narcan was just this benign drug that we could push away, secure in our thoughts that nothing untoward could happen…

    Take Care & keep up the great work!

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