BLS Certification Importance at the Height of the Opioid Crisis
BLS Certification Importance at the Height of the Opioid Crisis
by Mackenzie Thompson
Life Saver, AMC
posted on Mar 15, 2018, at 1:32 pm
Whether you are working on financial aid for going back to school for nursing or spending the season working outdoors in your favorite restaurant, spring can seem like it is all flowers. Unfortunately, it is accompanied by a growing risk, the opioid epidemic, which is worsening at an alarming rate. More than 200,000 Americans have lost their lives at the hands of the opioid epidemic, reports the Centers for Disease Control and Prevention (CDC).
Prescription opioids, like methadone, hydrocodone, and oxycodone, rest at the center of tragedy, but use of street opioids, like heroin, is increasing too. While powerful “come-back-to-life” drugs, like Narcan, have been touted as the end-all solution to the epidemic, says HuffingtonPost.com, someone with a BLS certification, even if not a health care professional, could perform life-saving measures until professional help arrives.
Opioid overdose deaths result from suffocation. The lungs slowly become paralyzed, and the person stops breathing. Someone with the right training could intervene and save the victim’s life. Misinformation and negligence of facts are part of the reason the opioid epidemic has continued, so understanding more about the epidemic is integral to humanity’s win in the fight to stop the opioid epidemic.
How Prevalent Is the Opioid Epidemic?
To understand the true prevalence of the opioid epidemic, consider its origin and effect on families around the country.
The opioid epidemic has roots in the late 20th century; health care providers took a renewed approach to managing chronic pain, using opioids to address the so-called “fifth vital sign of pain,” reports PBS. Opioids were heavily marketed as an addiction-free source of pain management. Opioid prescriptions peaked in 2010, following an outcry of addiction, but in 2015, the rate of prescribing opioids was still 3x higher than in 1999. Unfortunately, demand for the powerful prescriptions rose, and illegal drug dealers began to lace known illegal opioids, like heroin, with synthetic prescription opioids, including fentanyl. Demand for more powerful, synthetic drugs rose in tandem.
Opioid Abuse Spread Through a New Demographic
Unlike the past drug epidemics of cocaine, crack and methamphetamine, opioids affect Caucasians disproportionately. This derives from the presumed safety of opioids that permeated the industry at its inception. According to a 2015 New York Times report, 90 percent of new heroin users were Caucasian, breaking from the historic demographics affected by drug abuse.
Opioid Abuse Is Now a Major Problem of Both Urban and Rural Settings
The effects of opioids have moved into the Midwest as well. According to Newsweek, rural life comes with physical work, which increases risk of injury. Among workers literally doing the heavy lifting, a single injury could result in thousands of dollars lost. With employees seeking to get back to work faster, obtaining opioids through illicit means has become commonplace in the Midwest, areas thought to be isolated from the devastation of the epidemic.
Opioid Misuse and Overdose Rates Are Spreading and Increasing
In 2016, more than 2.1 million people misused opioids for the first time. Up to 170,000 used heroin for the first time, and nearly 1 million used heroin recurrently. More than 19,000 deaths will involve synthetic opioids, including fentanyl. Reports citing ethnic prevalence on the opioid epidemic for 2017 have not yet been released, but overall worsening of the epidemic is still evident. Men are more likely to develop an opioid addiction. While 16 states saw opioid overdoses increase 54 percent, others saw rates increase by 30 percent in 45 states, says the CDC.gov. In fact, Midwest opioid overdose rates rose by as much as 70 percent from July 2016 to September 2017.
The opioid epidemic statistics reflect the need to understand the risk of addiction and overdose resulting from both natural and synthetic opioids.
Who Exactly Is at Risk?
Everyone. Everyone reading this article could suffer an injury and turn to opioids for managing pain, and the rest is history.
Aside from avoiding opioids in general, people need to understand how to reduce risk for opioid abuse. In other words, those with known risk factors for addiction to opioids, as explained by the Mayo Clinic, must avoiding taking these substances, regardless of whether prescribed or obtained through illicit means.
These risk factors include the following:
- Past or present use of other substances, including tobacco and alcohol.
- Use of marijuana, even in areas with legal recreational marijuana laws, explains the National Institute on Drug Abuse (NIDA).
- Family history of substance abuse.
- Being an adolescent or in the early 20s.
- Co-occurring mental health conditions.
- Exposure to drug-conducive social environments.
- Access to prescribe drugs.
- Lack of understanding about the harm of prescription drug abuse.
What About Opioid Overdose?
Since risk of opioid abuse carries an inherent risk of opioid overdose, it is also important to understand the risk of overdose and its symptoms.
As explained by Healthline, these risk factors include the following:
- Someone with a known or developing tolerance to opioids.
- Relapse following a period of abstinence from substance abuse.
- Combining opioids, alcohol and other drugs.
- Using opioids through rapid-onset means of ingestion, such as injecting or snorting opioids.
Symptoms of an opiate overdose include:
- Pinpoint pupils
- Delayed, raspy or stopped breathing
- Slowed, faint or lack of pulse
- Loss of consciousness
- Limp body and unexplained weakness
- Cold, clammy skin
If someone exhibits these symptoms, it is time to intervene!
What Someone With BLS Certification Should Do When an Overdose Is Suspected
Debate exists over the best way to tackle the epidemic, including giving communities access to Narcan (naloxone) without a prescription. Paired with expected changes in the Affordable Care Act, increasing access to this medication may not the best solution. The same tactic has been considered and used by some police departments and other first responders beyond emergency medical technicians (EMTs), but another option, performing rescue breathing, may be just as effective at reducing mortality until EMTs arrive.
Check the Scene for Safety
Like any emergency, bystanders should always check the scene for safety. Depending on the method of ingestion, the onset of opioid effects can range from a few seconds when ingested intravenously or an hour or more afterward when swallowed in pill form. Someone could collapse or suddenly exhibit the symptoms of opioid overdose, even while driving or engaging in otherwise dangerous activities.
Check for Respirations and Circulation
Responders, even passersby providing aid, should respond to the event by checking for respirations and a pulse. Most often, respirations are barely noticeable, so it is important to look, listen and feel for respirations. Begin BLS. Also, check for a carotid pulse in the neck. If a pulse cannot be felt within five seconds, proceeding with BLS is essential to reducing risk of death.
BLS actions depend on the exact issues affecting the victim. If the person is not breathing, administer two rescue breaths. Due to public concern over infection risk when performing mouth-to-mouth, consider using a CPR mask, if available, or cup your hands together over the mouth and nose to act as a barrier. Form a tight seal to ensure air goes into the person’s lungs.
For people with larger facial features, as well as individuals with smaller hands, use the last two fingers of the hand closest to the top of the victim’s head to pinch the nose shut. This allow for a tight seal without cupping the nose. Of course, this method may not be possible in certain circumstances. As a result, administering mouth-to-mouth rescue breaths, regardless of a barrier is key.
However, if any opioids or unknown substances are on the mouth of the person affected, take extreme caution. These substances could be powerful opioids, so using a barrier may be necessary to prevent accidental ingestion of opioids when performing these measures.
Due to the severity of the epidemic, all adults, regardless of having their BLS certification, should consider purchasing disposal mouth-to-mouth shields or masks at a drugstore. These masks are thin, looking like a piece of plastic with a gauze pad in the middle that unfolds to lay over the victim’s mouth. Such devices are available online through retailers and some drug stores. Simply search for “CPR facial shield keychain” in your search engine of choice for local purchasing options.
To complete the process when alone on the scene, follow these steps:
- Check for a pulse. If no pulse can be felt, begin chest compressions at a rate of 100 compressions per minute. Although this is part of CPR, it is still considered BLS due to its basic skill set.
- Check for breathing. If not breathing, administer two rescue breaths between every 30 compressions. If the person begins breathing and still lacks a pulse, continue compressions, checking every two minutes for a pulse. If breathing stops at any point, resume rescue breathing.
- Contact 9-1-1. This step varies to each circumstance. Contact 9-1-1 after two minutes of performing BLS. As another option, dial 9-1-1 upon arriving to the scene, turn the phone on speaker, and tell the operator what’s happening while checking for pulse and respirations.
- If available, administer Narcan via spraying into the nose or mouth, depending on the manufacturer and directions on the vial of naloxone.
- Continue chest compressions and rescue breaths as needed until help arrives. The overdose does not just go away, so a person could begin breathing and return to respiratory arrest or enter cardiac arrest at any time.
If multiple people are present, divide the responsibility. Tell other people to help, and ask if they know CPR. If not, have them contact 9-1-1. Also, you can tell them to “breath” when performing chest compressions every 30 seconds. If they refuse, do not hesitate to perform rescue breaths on your own. Remember you are the link between survival and death for the victim.
Key Concerns in Helping Someone Suffering From Overdose Symptoms
As well as carrying a keychain facial mask or shield, individuals performing BLS or other emergency care to those with a suspected opioid overdose need to take a few additional precautions.
Avoid Coming Into Contact With Opioids or Unknown Materials
If opioids or unknown pills or substances are present, do not touch them. Opioids can be absorbed through the skin and mucus membranes. This measure includes taking steps to remove the dangers, like using a branch or available object to push unknown substances away from the victim, allowing a responder to begin BLS.
Wear Appropriate Personal Protective Equipment
As noted previously, anyone who may be in contact with opioids or an individual suspected of opioid overdose should wear personal protective equipment when providing care or BLS. This includes a rescue breather shield or mask and rubber gloves. In fact, some disposable mask shields may come with disposable gloves for this exact purpose.
Stay Vigilant Over the Victim Until Help Arrives, Including Monitoring Respirations and Heart Rate
Bystanders may not want to intervene when someone suddenly becomes ill and exhibits the symptoms of an opioid overdose. When you intervene, especially if BLS certified, staying on scene and providing life-saving measures is essential to ensuring survival of the victim. Do not turn over care until professional medical help arrives.
Remember to Help Others Affected During the Event, Like Children
Depending on the circumstances surrounding the overdose or event, other people could be injured and in need. Last year, several police departments began using shaming tactics, distributing images of parents who had overdosed in vehicles with children present. Those images remind society of the unspoken victims of overdoses, children, dependents and others suffering from another person’s opioid use. Provide aide to these children and people in all circumstances. If multiple people are present, tell them to help the other individuals affected.
A Person May Have Co-Occurring Mental Health Diagnoses
Although the symptoms of opioid overdose tend to result in extreme lethargy, someone could be going into an overdose and exhibiting other symptoms. Those with mental health disorders are more likely to abuse substances, including opioids. Be cautious of the actions and mental state of those using opioids. During treatment, withdrawal symptoms can also cause irrational behaviors, exacerbated by co-existing mental health disorders. Keep this in mind when interacting and providing care to anyone with a history of opioid abuse or overdose.
Get BLS Certified, and Make a Dent in Opioid-Related Mortality
The opioid epidemic is terrifying and ripping families apart. It is affecting all races, all levels of socio-economic status, everyone. No one is safe, but you can start to rebuild in the wake of the epidemic by getting your BLS certification. The opioid epidemic was built on a foundation of endless prescriptions. Without discussing politics and policies to reduce its prevalence, it must be undone by tending to the needs of each person suffering.
Becoming BLS certified ensures you are ready to respond when the opioid epidemic becomes a reality in your neighborhood, community, work environment or anywhere else. Even if you, your family members, and friends do not become victims of an overdose, the risk of someone overdosing and causing an accident still exists. Humanity must bear this risk, and having your BLS certification could lessen the burden, one life at a time.
Remember that ignorance will only contribute to the epidemic, so enroll in an appropriate course to help you prepare for fighting the epidemic. join the conversation, spreading awareness of opioids and BLS. Share your thoughts, opinions, and personal stories on the opioid epidemic through social media now.