William Manning MD
It is good to encourage lifesaving acts. But a focus on medication administration – whether naloxone or flumazenil or magnesium or antiarrhythmic – can be a distraction from the fundamental task. High-performance CPR is the correct initial response to an unresponsive, pulse-less individual; and while it can be argued that naloxone, like D50W or chicken soup, can’t hurt, the fundamental concern must be preserving survival while arriving at a determination of cause. There is every reason to encourage everyone to learn the ways that they can sustain their fellows, particularly as naloxone injection is useless in the absence of circulation and may be ineffective if circulation is not assisted. Single rescuer high-performance CPR and AED training is commonly available for free, and is increasingly provided to families and schoolchildren with impressive outcomes.
Cockpit crews are taught that if something goes wrong with the airplane, it’s important to assign one individual the task of FLYING THE PLANE while everybody else tries to figure out what went wrong and how to fix it. Planes have crashed because EVERYBODY in the cockpit was trouble-shooting and nobody flying. The same holds for an overdose; we need to make sure circulation and breathing ARE HAPPENING to get the antidote TO THE BRAIN!
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