Narcan

[roundout]

Odd story about that which doesn't involve liability but a good reason it's best handled through dispatch and MedLink is a story about one flight crew that had a cardiac arrest onboard, they got the passenger stabilized and flight control had notified the flight deck to divert to Gander (I'm probably going to screw up the airports) but they were over Goose Bay so the captain landed at the closest becaus "it's an emergency and I'm the captain".

Well, Goose bay is, at best 90 mins from a medical facility whereas if they went a bit further to Gander, it literally has a Hospital AT the airport.

 

[roundout]

The FAA says "thou shalt not board" but honestly speaking, they don't have the time resources (and often the interest) so you can be zonked out on pills and board a jet and usually the flight attendants onboard are the first to notice. Trust me, they want passengers out of the gate area and onboard the jet so they can work the next flight.

ETOPS you're never too far to divert because you're always x amount of minutes from a diversionary airport and if dispatch wants you to divert to Keflavik instead of continuing on to Heathrow and you continue to Heathrow, it can get really sticky. Overweight landings honestly aren't that big of a deal in a medical emergency and we have checklists and guidance for those situations.

If something medical happens onboard a jet, at least at my airline, we have this "situation room". There'll be dispatch, a supervisor, meteorology, a fleet specialist, probably a mechanic, sometimes even a medical professional on duty, a duty pilot (basically like a pilot representative that's looking out for your interests when it comes to pilot stuff) and either a hotline to MedLink and probably some other people.

So when the call comes to divert all of the deliberations, considerations, performance considerations and medical logistics have already been discussed and, for lack of a better word... decided. The biggest role you have during a medical, if things go pear shaped is relaying information over voice to MedLink if the onboard facilities aren't working. Even flight control can refile you as "Lifeguard" without your concurrence.

I'm just the Uber driver during a medical. Target? Dennys? Strip Joint? Send me the performance figures and hope they have hotels because we're probably going to time-out.

I’m trying to roleplay that scenario out at an airline with a, uh, less robust support network.

Yeah.

 

[derg]

I’m trying to roleplay that scenario out at an airline with a, uh, less robust support network.

Yeah.

Eh, I probably shared too much.

I'm very muh in my Kenny Roger's "The Gambler" phase of my professional career.

You should see me in meetings "Hey are you asking my opinion to validate what's already going to happen, or can I put a little "English" on the decision? Oh, it's already decided? Alright hand me the crayon box and the coloring book so I can keep myself busy"

 

[roundout]

Eh, I probably shared too much.

Nope. I’ll share, too, if it makes you feel better. Most likely via a different medium, but whateva.

I'm very muh in my Kenny Roger's "The Gambler" phase of my professional career.

You should see me in meetings "Hey are you asking my opinion to validate what's already going to happen, or can I put a little "English" on the decision? Oh, it's already decided? Alright hand me the crayon box and the coloring book so I can keep myself busy"

I have thoughts about this as well, but, uh, see above.

 

[CoffeeIcePapers]

Oh, joy.

"Where's the insulin?!"

"Oh, some dude on a news-opinion show said that Type-2 Diabetes on a corpulent person has GOT to be from overindulgence, which is a sin, so there was this boycott of the airline until we got rid of it"

Having someone die on your airplane from a situation which could have been preventable is a monkey I don't want to carry around for any circumstance.

Remember, Jesus said that if man taketh jelly donut, he will join satan in hell.

 

[Autothrust Blue]

I’m trying to roleplay that scenario out at an airline with a, uh, less robust support network.

SkyWest didn't have squat for medical decision support.

Cold beer stories, plural.

 

[roundout]

SkyWest didn't have squat for medical decision support.

Cold beer stories, plural.

Pfff. I will put my ultra low tales (see what I did there) up against anybody except those who fly rubber dog toys out of Hong Kong.

Let’s make that happen, though.

 

[KaiGywer]

The only thing that makes me pause about carrying it (not like it's even up to me) is what happens after someone is Narcan'd, though I'd assume that in the event of an OD we're going to find ourselves diverting anyway, so, whatever.

Medical decision support wins the day, etc.

From someone who has given numerous doses of Narcan over the last few years, it is still a medical emergency. As mentioned in the next quote, it's a temporary solution. While Narcan in and of itself has no negative effects, the patient sometimes will be "violent" as they wake up since they have no clue where they are or what happened.

Narcan is only a 30-60 minute solution to a very immediate problem.

It’s not a cure-all to an overdose. It’s a stabilizing capability to where urgent transport and care can be administered.

I think this is more my issue with Narcan, people think it’s just an instant fix to a serious problem, and like he said that problem is what the hell causes a person to take enough opioid to do what Narcan is there to prevent.


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Part of the problem is doctors prescribing excessive legal opiates to a pain patient, who then becomes addicted. Eventually, their legal source runs dry and they start buying "off brand" from "unlicensed pharmacists". These are more often than not an unknown amount of fentanyl, which then causes them to OD.

 

[derg]

SkyWest didn't have squat for medical decision support.

Cold beer stories, plural.

We had zero at Skyway.

But then the most critical leg was what, MKE-GRR over the lake?

 

[roundout]

We had zero at Skyway.

But then the most critical leg was what, MKE-GRR over the lake?

On that leg, it actually works. Cash me flyin PHL-SJU out in WATRS tho.

 

[derg]

On that leg, it actually works. Cash me flyin PHL-SJU out in WATRS tho.

Truth!

 

[MikeD]

From someone who has given numerous doses of Narcan over the last few years, it is still a medical emergency. As mentioned in the next quote, it's a temporary solution. While Narcan in and of itself has no negative effects, the patient sometimes will be "violent" as they wake up since they have no clue where they are or what happened.

A medical unit or ALS ambulance has the requisite drugs available to control a patient’s OD reversal from narcan. Simply possessing the nasal shot does not have that. The number of ODs that have been brought back to life by LE, for example, only to now have an angry and highly combative person on your hands, necessitating various levels of use of force, has been an occurrence. Solving one issue can create another larger issue, and one that’s difficult enough to handle on the ground, much less in a tube up in the flight levels.

 

[Massapequa!]

From someone who has given numerous doses of Narcan over the last few years, it is still a medical emergency. As mentioned in the next quote, it's a temporary solution. While Narcan in and of itself has no negative effects, the patient sometimes will be "violent" as they wake up since they have no clue where they are or what happened.

A medical unit or ALS ambulance has the requisite drugs available to control a patient’s OD reversal from narcan. Simply possessing the nasal shot does not have that. The number of ODs that have been brought back to life by LE, for example, only to now have an angry and highly combative person on your hands, necessitating various levels of use of force, has been an occurrence. Solving one issue can create another larger issue, and one that’s difficult enough to handle on the ground, much less in a tube up in the flight levels.

A medical unit or ALS ambulance has the requisite drugs available to control a patient’s OD reversal from narcan. Simply possessing the nasal shot does not have that. The number of ODs that have been brought back to life by LE, for example, only to now have an angry and highly combative person on your hands, necessitating various levels of use of force, has been an occurrence. Solving one issue can create another larger issue, and one that’s difficult enough to handle on the ground, much less in a tube up in the flight levels.

That is a valid concern. While Narcan is effective at reversing the effects of an opioid overdose, it does not address the underlying issues that led to the overdose, such as addiction and depression. As you mentioned, patients who are revived with Narcan can be confused, combative, and even violent, which can create a challenging and dangerous situation in a high-altitude environment like an airplane. In addition, while Narcan can save a person's life in the short-term, it does not address the long-term health consequences of opioid addiction, which can lead to chronic health problems and even death over time. Therefore, it is important for airlines to have robust medical decision support and emergency response protocols in place to effectively manage these situations and ensure the safety and well-being of all passengers and crew.

 

[derg]

That is a valid concern. While Narcan is effective at reversing the effects of an opioid overdose, it does not address the underlying issues that led to the overdose, such as addiction and depression. As you mentioned, patients who are revived with Narcan can be confused, combative, and even violent, which can create a challenging and dangerous situation in a high-altitude environment like an airplane. In addition, while Narcan can save a person's life in the short-term, it does not address the long-term health consequences of opioid addiction, which can lead to chronic health problems and even death over time. Therefore, it is important for airlines to have robust medical decision support and emergency response protocols in place to effectively manage these situations and ensure the safety and well-being of all passengers and crew.

@miked… no… no…. LEAVE IT! No threats.

 

[BobDDuck]

Part of the problem is doctors prescribing excessive legal opiates to a pain patient, who then becomes addicted. Eventually, their legal source runs dry and they start buying "off brand" from "unlicensed pharmacists". These are more often than not an unknown amount of fentanyl, which then causes them to OD.

The other I'm seeing a lot of, is fentynal ending up in other gray market drugs. Somebody buys a bunch of "zanax" off of their local dealer, and either due to cross contamination or intentionally, there is trace amounts of fentynal onboard. They get on a plane, pop what they think is a zanax to relax, and it's off to the races.

 

[Lawman]

The other I'm seeing a lot of, is fentynal ending up in other gray market drugs. Somebody buys a bunch of "zanax" off of their local dealer, and either due to cross contamination or intentionally, there is trace amounts of fentynal onboard. They get on a plane, pop what they think is a zanax to relax, and it's off to the races.

Fentynal represents a sea change in the smuggling market for drugs.

It’s similar with how Marijuana was a big profit drug until Cocaine supplanted it coming up from the South. With fentanyl The density of product smuggled vs the profit it can achieve is just so screamingly high it’s becoming a widely available chemical catalyst in the local manufacturing processes. And it’s stupidly easy to manufacture as far as opioids.

It also doesn’t help the Chinese are happy to turn a blind eye to the deliberate manufacture of it or it’s precursor chemicals to sell directly to Mexican cartels because they know it will end up in the US. Yet another thing they’ve been exporting from Wuhan en masse.


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[///AMG]

I'd be terrified to be a drug user/addict right now. We just lost the daughter (19 yo) of a family friend about a year ago to an accidental OD that was due to fentynal laced "prescription" type drug experimentation.

 

[Lawman]

I'd be terrified to be a drug user/addict right now. We just lost the daughter (19 yo) of a family friend about a year ago to an accidental OD that was due to fentynal laced "prescription" type drug experimentation.

It’s not just drug addicts in the traditional sense anymore though. OD’ing is a loaded statement that conjures up images of a person with a needle in their arm in some crappy condition. Nobody talks about the mom in the suburbs or you grandparents that bought pills from a “pharmacy” on that cruise to Mexico, because they were cheaper. That’s where the “just decriminalize everything” logic stops tracking.

Like yes legalize weed and stop treating it like alcohols boogieman cousin. Develop means and methods to treat it the same as we do smoking or alcohol because the danger to the user and general public is really not there.

But there is a reason we say “controlled substance.” It’s not just the government saying this will make you feel funny so you can’t have it. Just like buying/manufacturing mining explosives it is controlled from its precursor forms to its manufacture to its movement and distribution. We do that specifically to prevent risk to a patient seeking the same effect as any over the counter medicines, but with a diligence to the absolutely deadly nature of the situation. Now because of a combination of factors we have what look like legal drugs entering the supply pool from outside the legal supply chain. And a lot of people simply don’t respect the fire they are playing with here. There is a reason you can’t just buy the stuff the anesthetist has in their bag at the store. You are in no way as a layman safe to be using it either on yourself or others.


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[Boris Badenov]

*Looks around at all of the D/Hing crew in the back of the big brown poopbox*. Well, they may belch, fart, and snore, but I don't think we're going to need any Narcan.

 

[FXMXC]

The other I'm seeing a lot of, is fentynal ending up in other gray market drugs. Somebody buys a bunch of "zanax" off of their local dealer, and either due to cross contamination or intentionally, there is trace amounts of fentynal onboard. They get on a plane, pop what they think is a zanax to relax, and it's off to the races.

^^^This^^^ As someone who lost my only sibling to fentanyl I can relate. In my brothers case he was an addict but I am a admin in an overdose group and lots of kids are dying from it cuz they thought they got a Xanax but got fentanyl instead . I could see someone taking something to calm them during a flight like Xanax bought off the street and have it laced or even pure fentanyl. Don't really know if carrying Narcan will help as to what people have mentioned above in the case of fentanyl it might require multiple doses of Narcan and in the case of my brother the ME said Narcan may not have saved him said he was dead by the time he hit the floor.