Drexel University Overdose Public Health Paper

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Drexel University

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How to perform the Rescue Position Step 1 Left hand up Step 2 Right arm across neck Step 3 Hand on knee Step 4 Pull up on knee, right toe to left knee Step 5 Hand on bent knee and elbow Step 6 Pull towards you Step 7 Stay with them until help gets there When to use the rescue position and why After narcan has been given and the person is breathing on their own If they are not fully awake, you always want to put them on their side (rescue position) People have a tendency to throw up after a reversal and can choke on their own vomit Also being on your side opens up your airway more than being on your back and allows a person to breath more easily 2/16/2022 Department of Public Health Overdose Awareness and Reversal Training 1 OVERDOSE AS A PUBLIC HEALTH ISSUE In 2020: 1,214 Deaths / 81% of which Fentanyl was present . In 2019: 1,150 people died from drug overdoses In 2018: 1,116 first slow decrease in deaths in some time / more access to Narcan In 2017 there were 1,217 deaths due to overdose w/ a 10% decrease in the last quarter 2016: 907 overdose deaths in Philadelphia 2015: 702 overdose deaths in Philadelphia 2014: 628 deaths overdose deaths in Philadelphia 2013 460 overdose deaths in Philadelphia 2012: 513 overdose deaths in Philadelphia 2011: 489 overdose deaths in Philadelphia 2010: 387 overdose deaths in Philadelphia 10% where fentanyl was present. Opioids were present in more than 50% of overdose deaths (Cocaine: 16%, Benzos: 14%, Alcohol: 9%, other: 11%) Source: Philadelphia County Medical Examiner’s Office 2 1 2/16/2022 2016 & 2017 BY THE NUMBERS 3 3 4 2 2/16/2022 ? ● So, what population of our communities do you think are at risk of overdosing? ● What do they look like ? ● What do you think puts those individuals at risk of overdosing ? 5 Crack Outbreak and Other Surges ● “At least 20 people in the Powelton Village and Mantua neighborhoods were hospitalized over two weeks. Two fatalities. The victims were predominantly African American, two-thirds male, most between 40 to 50 years old. And according to health officials, many of them had more in common: they were adamantly cocaine users – not opioids.” 6 3 2/16/2022 Drug overdose deaths involving synthetic opioids and methamphetamine have shifted geographically.2 From 2018 to 2019, the largest increase in death rates involving synthetic opioids occurred in the West (67.9%). The largest increase in death rates involving psychostimulants occurred in the Northeast (43.8%). Previously, the East had the highest increases in deaths involving synthetic opioids, and the Midwest had the highest increases in deaths involving psychostimulants. No state experienced a significant decrease from 2018-2019. 7 7 8 4 2/16/2022 9 10 5 2/16/2022 COUNTERFEIT PILLS 11 11 Opioids are the tip of the iceberg Other drugs are on the rise in Philadelphia 12 6 2/16/2022 Types of Opioids Prescription Opioid Treatment Prescription Painkillers • Hydrocodone (Vicodin or Lortab) • Oxycodone (OxyContin, Roxicodone, Percodan, Percocet) • Hydromorphone (Dilaudid) • Morphine • Codeine • Fentanyl (Duragesic, Actiq, Sublimaze) • Methadone (Dolophine, Methadose) • Buprenorphine (Buprenex, Suboxone, Subutex, Belbuca) • Vivitrol Illicit Opioids • Heroin • Street Bought Fentanyl • Carfentanil 13 13 Harm Reduction Harm reduction aims to reduce the negative health and social consequences associated with drug use. Harm reduction is a set of public health principles that give respect and rights to people who use drugs. These include: • Accepting that drug use occurs • Seeking to minimize the harmful effects of drugs rather than ignore or condemn people who use • Calling for judgment-free resources for people who use drugs • Being honest about the risks of drug use Harm Reduction Coalition 14 14 7 2/16/2022 What puts people at risk for overdose? • Tolerance changes (24-48 hours of non-use) • Physical health (liver functioning, weight loss, immune system, dehydration, breathing conditions, etc.) • Mixing drugs • Variation in strength and content of ‘street’ drugs or pharmaceuticals • Switching mode of administration (taking pills, snorting, injecting) • Using alone Harm Reduction Coalition 15 Checking for OD Symptoms • • • • • • Extreme sleepiness/nodding/can’t stand on own/ Eyes rolling back w/ difficulty speaking Slow or irregular breathing Not snoring regularly, not catching breath during sleep Gurgling Turning pale, blue lips, grayish or ash like complexion on darker skinned persons Not an opiate overdose if foaming mouth, breathing and snoring regularly. 16 16 8 2/16/2022 • Wear gloves if you have them. • Safely remove hazardous materials (including syringes, drugs, broken glass, etc.) that may be present. • Ask people who are anxious or not helping to step aside. • If possible, safely place the person on the floor, without hurting yourself or them. • Keep in mind, a person who has been reversed could be disoriented allow space for person to acclimate. 17 17 If you see someone who may be overdosing First, try to wake the person up. HEY ARE YOU OKAY? DO YOU NEED ANY HELP? Sternum Rub Apply pressure/pain Still no response? 18 9 2/16/2022 Bed Nail Press ● Press nail or side of finger mild to hard for 1 Mississippi! 19 Call 911 & Check the area Give the exact location Describe the symptoms Clear the area of hazardous material before you start to work on person overdosing 20 10 2/16/2022 Take Action Giving naloxone CHECK THE TIME If the person does not respond within 3-5 minutes, give a 2nd dose Works for 20-90 minutes 21 ADMINISTER NARCAN 22 22 11 2/16/2022 Even if naloxone is not available, rescue breathing will buy time. Clear the airway Tilt head back Lift chin Pinch nose Give 1 breath every 5 seconds Do not give compressions unless the heart has stopped 23 24 12 2/16/2022 If the person starts breathing on their own, but has not yet become consciousput them in the recovery position. 1. Lift right arm above head 2. Put left hand on their right shoulder 3. Lift left leg up at the knee 4. Roll individual towards you & onto their side 25 Types of naloxone 26 13 2/16/2022 Types of naloxone Each EVZIO prescription comes with a black-and-white Trainer that can be used for practice 27 Overview of response • • • • • • • Stimulation Call 911 Naloxone/Narcan Airway/ Check Rescue Breathing Evaluate Observe, Wait  Place them in the recovery position  Stay with them,  Naloxone is temporary! 30 to 90 minutes blocks receptors does not flush the system 28 28 14 2/16/2022 PA’s Standing Order is a prescription for any PA resident ANYONE can walk into a pharmacy and get naloxone without a doctor’s prescription. It is covered by most insurance plans. Provides immunity for those who report and/or respond to an overdose. In other words, you cannot get in trouble for calling for help 29 CONTACT INFORMATION Elvis Rosado Health Educator elvis.rosado@phila.gov (267) 407-8231 30 30 15 2/16/2022 THANK YOU 31 www.phila.gov/opioids 32 16 Due Tuesday by 5:15pm Points 30 Submitting a file upload Naloxone Training Directions Students will conduct THREE overdose response trainings. Trainings can be held in person with members of your household or virtually over Zoom, FaceTime, etc. You can train one person per session or multiple but you must conduct three separate trainings. Trainings must include information on how trainees can get naloxone. If they cannot get naloxone through their insurance at a pharmacy, speak to an instructor. After you've held three trainings, write a brief (2-3 pages) reflection paper. Some general information to include is: 1. Who did you train and how? 2. How was the experience of training other people? 3. What happened during that training that you expected? That you didn't expect? 4. Any thoughts about how your audience received the training, questions they asked, etc. 5. Anything you would do differently next time.
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Reflection Paper on Overdose Response Training

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Overdose Response
Overdose is a common emergency and a public health issue in the US, with the cases of
substance overdose surging over the years. Statistics show that overdose deaths in Philadelphia
have been on the rise since 2010, hitting over a thousand in 2017 (Rosado, 2022). There were 1
214 mortality cases in 2020. With more accessibility to naloxone in 2018, Philadelphia
experienced the first slow decline in deaths in some time. There were more overdoses of fentanyl
in 2021 than all overdoses in 2016 (Rosado, 2022). Opioids are the most commonly involved
drugs in overdosage. The three types of opioids overdosed include prescription painkillers such
as fentanyl and oxycodone, opioids prescribed for treatment such as methadone, and illicit
opioids such as heroin. There is, therefore, the need for creating overdose awareness and training
individuals on reversal of drug overdose.
People are put at risk of overdose when they use the drug alone, switch the mode of
administration, mix the drugs, and their tolerance to the drug changes after forty-eight hours of
non-use. Variations in the content and strength of the drugs also put people at risk of overdose.
Overdose symptoms include but are not limited to gurgling, extreme sleepiness, irregular
breathing, skin turning pale. The presence of foam in the mouth, regular snoring, and breathing
indicates that the overdose is not due to opiates.
Response
In case of overdose, try to wake the ...


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