The effects of fentanyl arenB次元官网网址檛 just hitting those unknowingly ingesting this deadly drug.
West Shore paramedics and first responders deal with this crisis every day and have had to taken precautionary measures to protect their own. B次元官网网址淭hereB次元官网网址檚 another side to the whole opioid crisis and thatB次元官网网址檚 the effect on first responders and paramedics B次元官网网址� It takes a massive toll,B次元官网网址� said View Royal Fire Chief Paul Hurst. B次元官网网址淭hatB次元官网网址檚 first and foremost my concern, the cause and effect itB次元官网网址檚 having on my staff B次元官网网址� We watch that very closely.B次元官网网址�
With increased access to doctors, therapists and a team of medical professionals, Hurst said, keeping his firefighters healthy is priority one for the department. B次元官网网址淲e look after each other,B次元官网网址� he said, adding they have also expanded their critical incident debriefing sessions. B次元官网网址淚f my staff are well, they can take care of the community.B次元官网网址�
But itB次元官网网址檚 not just taking a toll on the firefighters who are often first on a scene of a medical call.
B次元官网网址淭he paramedics are the front line, theyB次元官网网址檙e doing this every day,B次元官网网址� Hurst said. And itB次元官网网址檚 a job that often goes unnoticed. B次元官网网址淭hey donB次元官网网址檛 get enough credit for what they do B次元官网网址� Their job is thankless; they do not receive the praise and support other agencies get.B次元官网网址�
Brad Cameron, B.C. Emergency Health Services district manager of Victoria, added, B次元官网网址渋t strikes home B次元官网网址� It effects us.B次元官网网址�
To battle staff burnout and the increased workload, Cameron has scheduled an additional ambulance on Fridays, Saturdays and Sundays, statistically the busiest days for overdoses. B次元官网网址淵ou get to a point when you get empathy burnout. You hit a critical point B次元官网网址� WeB次元官网网址檝e had more than a few people crash and had to take time off,B次元官网网址� he said.
B.C. EHS has also increased the availability of its critical incident stress team and put other safeguards in place to protect its team.
With no municipal boundaries to confine them, paramedics cover a wide area B次元官网网址渁nd they can go from OD to OD,B次元官网网址� Hurst said.
HeB次元官网网址檚 heard of situations where paramedics revived a patient, transported them to hospital, then had to come to their aid again later in the same shift.
B次元官网网址淗ow do you rationally deal with that? YouB次元官网网址檙e trying to help these people, but itB次元官网网址檚 just so out of control.B次元官网网址�
The relentless number of overdose calls is putting a huge strain not only on naloxone and other medical supplies, but also on staff, Cameron said.
Typically, when paramedics respond to an overdose involving heroin, he said, they are on scene for 10 to 15 minutes before they start seeing positive responses from patients. But when fentanyl is involved, paramedics can be on scene for more than 25 minutes. They can also encounter other problems that result in longer callouts.
B次元官网网址淲hen you wake someone up, theyB次元官网网址檙e pissed off because youB次元官网网址檝e taken away their high and theyB次元官网网址檙e already hypoxic, so theyB次元官网网址檙e kind of out of it,B次元官网网址� Cameron said, noting that often patients will get hostile.
Hurst added, B次元官网网址渢his isnB次元官网网址檛 a typical medical call B次元官网网址� Those have expected outcomes.B次元官网网址�
Overdose calls are unpredictable, he said. They can morph from an overdose to a cardiac arrest, to a wife performing CPR on her husband, to first responders arriving, administering naloxone and the patient regaining consciousness, then refusing further medical treatment.
B次元官网网址淚t goes from one level to another B次元官网网址� managing that is challenging,B次元官网网址� Hurst said, adding first responders have had to radically change their approach. B次元官网网址淪ome of these drugs are so powerful I donB次元官网网址檛 know if thereB次元官网网址檚 anything first responders can do B次元官网网址� ItB次元官网网址檚 literally Russian roulette (for users); you donB次元官网网址檛 know what youB次元官网网址檝e injected and what the outcome will be.B次元官网网址�
Cameron added, B次元官网网址渢hese people have no idea of what theyB次元官网网址檙e getting into.B次元官网网址�
For recreational users, Hurst said, B次元官网网址淚 would hope it would give people pause to reconsider.B次元官网网址� But he acknowledged addiction is a tricky beast. B次元官网网址淚 donB次元官网网址檛 think weB次元官网网址檙e going to stop the drug use, itB次元官网网址檚 how we manage it.B次元官网网址�
Another killer hits the streets
West Shore first responders and paramedics continue to battle a deadly killer that is fentanyl. Making matters worse is the appearance of carfentanil on the illegal drug market.
This synthetic opioid, sometimes used to tranquilize elephants, is similar to fentanyl, but 100 times more potent and an estimated 10,000 times stronger than morphine. With confirmed reports of the drugB次元官网网址檚 presence in Vancouver and even as close as Nanaimo, Brad Cameron, B.C. Emergency Health Services district manager for Victoria, said it's only a matter of time before it gravitates to Victoria. "We've seen evidence it's already here," he added.
Roughly six weeks ago, local paramedics encountered a patient who required 10 milligrams of naloxone before showing any sign of a positive response. With an average dose containing 0.4 milligrams of the drug, Cameron said it's not uncommon for patients to receive multiple doses. That usually means a patient has been administered less than 2 milligrams.
"The amount of naloxone we're going through is skyrocketing," he said, adding that is a reflection of the potency of drugs and the number of calls they are receiving.
Like everything, supply and demand also factors into price and Cameron said naloxone is more expensive now than ever.
According to a Ministry of Health spokesperson, there was a modest increase to the cost of naloxone when the province switched suppliers a few months ago, but she would not release the cost per dose. The B.C. Centre for Disease Control's current supplier is Teligent.
Roughly 16,500 naloxone kits were distributed at no charge in 2016 through the province's Take Home Naloxone program. Kits can also be purchased by the public at many pharmacies for roughly $50. Pharmacists can provide instruction on how to use the kit and more training is available online at .
If you missed Part One of this two-part series, .
katie@goldstreamgazette.com
