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2018 Annual Report • Fire Department • St. Anthony Village, Minnesota <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />36 | P a g e <br /> <br />While providing ventilations is still the first action in any case of someone not breathing, if it is <br />suspected opioid related apnea, the medical term for someone who isn’t breathing, Narcan can <br />be used to reverse the effects of opioids on the brain. Identifying incidents of opioid related <br />apnea can be as simple as looking for key signs and symptoms that are dead giveaways. Pin <br />point pupils, fresh injection sites, or even signs as obvious as needles or prescription medication <br />bottles present on the scene. If any of those signs are seen by the first responders, Narcan can be <br />administered. Narcan has the added benefit of also being inert when given to patients who <br />aren’t in fact suffering from opioid overdose. Once administered, Narcan acts by finding the <br />same receptors that opioids latch on to and kicking them off, as it has a higher affinity to <br />connect to those receptors than many common opioids, such as heroin or commonly prescribed <br />painkillers. Imagine those opioids and Narcan being like magnets, only Narcan is stronger than <br />most opioids and claims a spot on the affected receptors. <br />It acts quickly, as it’s administered intranasal, and the nose is lined with many capillaries that <br />absorb the medication and quickly get it to the brain. Within minutes, the patient regains <br />consciousness and can maintain their own airway and breathe on their own. Despite the change <br />in patient status, they are always transported to the nearest appropriate hospital by Paramedics, <br />who have additional Narcan on the ambulance to provide if the patient begins to go <br />unconscious again. <br />While Narcan is a helpful tool in most opioid overdoses, the heroin has been processed to be <br />stronger than before, and often is laced with fentanyl and carfentanil, two opioids that are so <br />potent, that the effects of single Narcan doses often aren’t enough to reverse the overdose. For <br />reference, heroin is three times stronger than <br />morphine, fentanyl is 30-50 times stronger than <br />heroin, and carfentanil is 5000-10,000 times <br />stronger than heroin. A dose of carfentanil the <br />size of a grain of sand is considered a lethal <br />dose. Narcan is a very valuable tool that has <br />been used successfully many times, but it is still <br />used in conjunction with providing oxygen to a <br />patient and addressing other possible life <br />threatening symptoms. <br />Figure 4: Lethal doses of heroin, fentanyl, and carfentanil