ABC 6 News Investigates: Responding to a Crisis

February 02, 2018 01:13 AM

(ABC 6 NEWS) – The opioid crisis is continuing to affect the health care system in the United States.

According to state officials, the number of hospital visits has gone up across Minnesota and Iowa.


The trend is having a direct impact on emergency medicine.

"When an unresponsive call comes in we have a variety of things to consider, are they breathing, do they pulse, was this an overdose, was it from a medical cause, is it a stroke, is it a heart attack, is it a seizure, is it somebody who is intoxicated," said John Bacigalupo.

Bacigalupo is a full-time EMT with the Hayfield Ambulance. He says responders are looking for different elements on scene to piece together an overdose.

"The first thing is the accidental overdoses, we see that with elderly patients and folks that were prescribed ligament pain pills for injuries that they received and then we see the heroin overdoses from negligent and overuse of heroin. We've also seen heroin cut with carfentanil and different other synthetic opiates that cause significant more problems," added Bacigalupo.

Despite the different types of an overdose, it's crucial for first responders to be prepared for anything.

“The training that we do is scenario based it’s designed to be realistic, it's designed to induce stress in the new EMT and causes them to make critical decisions to treat a patient under stress so that they are prepared for those stresses when they hit the street on a real call, with a real call, with a real overdose,” says Bacigalupo.

When responding to an overdose both police and first responders carry naloxone or narcan. It's a medication that can be used to rapidly reverse the side effects of an opiate overdose.

“Something important to note, folks that overdose on carfentanil or have taken a large amount of opiate, the amount of narcan we carry in the ambulance is not enough usually to take care of folks they need rapid transport to a hospital usually to get a much larger dose of naloxone," said Bacigalupo.

Naloxone treatment gives a patient time anywhere from three to 90 minutes for transport.

"The problem of opiates can begin with prescriptions but it's certainly not limited there. There are nonprescription medications that people are acquiring illegally or there are groups that are making these kinds of medications or drugs and releasing them into communities," said Dr. Venkatesh Bellamkonda

Dr. Venkatesh Bellamkonda is an assistant professor of emergency medicine at Mayo Clinic in Rochester.

"This crisis is affecting our Saint Marys emergency department, we are seeing people from all over the world and especially all over the United States coming here with conditions that are unexplained and some of them the explanation comes down to the fact that they have been treated with prescription pain meds for so long that now those pains are actually a sign of dependence,” added Dr. Bellamkonda.

But Dr. Bellamkonda wants people to be aware of the other side of addiction.

“A lot of times people think opioid misuse or abuse is really about trying to get high or have this pleasurable feeling, but it takes other forms, it can be just that the body's own biochemistry, like the receptors, have received that medicine for so long or in such a way that they now need it," said Dr. Bellamkonda.

According to the Iowa Department of Public Health, there were over 350 emergency department visits and over 300 hospitalizations related to opioids in 2016.

In Minnesota, there were more than 1,100 emergency room visits for opioids and despite a slow decline, there was more than 2,000 nonfatal hospital treated opioid overdoses.

"There are a lot of discussions I have with patients about the fact that even though they have some painful condition or something that is really disruptive to them that I don't think it’s right for them to have these medicines," says Dr. Bellamkonda.

In 2016 Minnesota had 395 total opioid overdose deaths compared to 336 in 2015.

In 2016 Iowa had 180 opioid-related deaths compared to 163 in 2015.

"I'd like to remind people that a lot of people that overdose on heroin or people that are around people that overdose on heroin is very hesitant to call 911 for help for that person," said Bacigalupo.

Local EMT’s say people need to put aside legal consequences from the law and call if they need help.

"Let us come out and help you that's what we are here for there's always help out there for people too like we don't like seeing this type of stuff," said Bacigalupo.


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