How much do you know about an opioid overdose and how would you handle one?
The Harrison Board of Education got a little bit of education last week from district RN Tiffany Roberts about opioids, or opiates.
Robertson explained that opiates include prescription medications like morphine, codeine, methadone, hydrocodone, oxycodone, fentanyl, hydromorphone and buprenorphine, as well as illicit heroin.
She said such medications are prescribed following surgery and some cough syrups contain codeine.
Arkansas has the 35th highest drug mortality rate in the United States.
“And this number is on the rise,” Robertson said.
She went on to say that a government survey indicated Arkansas ranks highest in the nation for the percentage of students in grades 9-12 who have taken pain medication without a prescription.
Overdoses can be intentional or accidental. If one pain pill isn’t making the difference, maybe they take another and another.
“And before you know it, you’ve taken too much,” she said.
Arkansas Act 284 allows pharmacies to dispense Narcan, which is used to treat opioid overdoses, without a prescription. In June, Robertson and fellow RN Judy Morris, who has since gone to work for the Green Forest School District, went to a press conference in Little Rock where Gov. Asa Hutchinson announced the availability of Narcan for school nurses because they were two of the first trained in the use of Narcan kits.
A federal grant paid for Narcan kits for all school nurses who took the online training. The cost of replacing those kits will be up to the district at about $40 per kit.
“I think that would be worth it,” she said.
Narcan is an opioid antagonist that can be used to temporarily reverse the effects of an opioid overdose. It begins to work in one to three minutes and can last for 30 minutes or more. Narcan is administered through a nasal spray, but it will cause no adverse effects if the health problem isn’t an opioid overdose.
“If it was another medical emergency, you’re not going to hurt the patient.”
If the Narcan kit is put into use, Robertson said, EMS is notified immediately and they can take further steps.
Aside from the Narcan kits, Harrison School nurses also have epinephrine and albuterol thanks to the efforts of Dr. Blake Chitsey and Stephanie Mallett. Albuterol can be used for anyone who appears to be in respiratory distress, whether or not it has been prescribed. Epinephrine is used for anyone suspected of having an anaphylactic, or allergic, reaction that can cause swelling or difficulty breathing.
Epipens are provided to the district at no cost and all elementary schools will be provided with both adult and pediatric doses, while the middle and high schools will have adult doses.
There is no current program to pay for albuterol, but it will be an annual cost to the district of about $40 per school for inhalers.
“I’ve said it once, I’ve said it twice, if we only save one life it will be worth it because every life is worth saving,” Robertson said.
Robertson said the school has practiced medical lockdown drills that will keep all students out of hallways until EMS is on scene and has transported a victim for treatment.
“I am so happy to have these tools in my toolbox now, because especially with these three life-threatening conditions, seconds matter,” Robertson said.