Consistent with this significant rise in related call volume and response trends and reminiscent of the "Tango & Cash" & "China White" crisis of the past, UMDNJ - EMS has issued a "Emergency Memorandum" to all EMS systems and Emergency Departments. Additionally, NYC-EMS has issued an Operations Order to alert all pre-hospital care providers of the potential for increased activity related to this influx.
Patients usually present with a significantly altered mental state followed by respiratory and cardiac arrest. Resusitation of these patients require large doses of Naloxone (Narcan) and patients if successfully resusitated often experience agitation and seizures. Additional pharmacological intervention with physostigmine and diazepam may be required to manage these clinical findings.
It is not unusal to discover more then one patient experiencing these problems at a given location. Experience with other "herion crisis" has taught EMS systems and providers to be prepared by increasing availabilty of opiate inhibitors/antagonists and bag valve mask manual resusitators to enhance the efficacy of patient care, at scenes where multiple patients are being encountered.
All EMS systems and Emergency Departments are encouraged to remain alert for patients presenting with similar symptoms and patient presentation trends. Caution is being urged by ERRI for other parts of the country, due to the fact that this drug may have been exported from the NYC/NJ area.
Responding agencies may notify ERRI of occurances of this type so that information can be further disseminated by calling (312) 631-ERRI -24hr. HOTLINE, faxing the information to (312) 631-4703, or e-mail enn@emergency.com.
Source: NYC*EMS/UMDNJ-EMS
(c) Emergency Response & Research Institute
AUTH: C. Staten/ERRI/12-29-95/1700CST