Fentanyl suckers

[LucidResq]

Apparently a local FD is investing in fentanyl lollipops for their ALS units.

Whatcha think? Sounds kind of ridiculous to me.

I hope it's just a rumor because I can see so many problems with that just as a basic student... like calculating dosages and stuff. Why not just give it IV so you can say "this is how much I gave them" without a doubt?

 

[firecoins]

Apparently a local FD is investing in fentanyl lollipops for their ALS units.

Whatcha think? Sounds kind of ridiculous to me.

I hope it's just a rumor because I can see so many problems with that just as a basic student... like calculating dosages and stuff. Why not just give it IV so you can say "this is how much I gave them" without a doubt?

It is measured in how many licks it tkes to get to the morphine bubble gum center.

 

[Ridryder911]

There great! They come in measured 100, 200, 300 mcg (per weight based) dosages. A great way of providing analgesics. I used them a lot before establishing large IV lines, they take only a few minutes to work and wear off in about 20 minutes without all the s/e of other analgesics.

Not ridiculous at all.

R/r 911

 

[el Murpharino]

Do they come in cherry and grape flavors?

 

[Ridryder911]

Do they come in cherry and grape flavors?

Yes, they do (both flavors)

 

[EMT19053]

Gee Rid, I think they wanted to have a good laugh with this one and you burst their bubble (gum center). lol

 

[SwissEMT]

Apparently a local FD is investing in fentanyl lollipops for their ALS units.

Whatcha think? Sounds kind of ridiculous to me.

I'm envious. I wish my medical director had the common sense to allow multiple pharmacological options to the provider.

 

[eggshen]

Hola Lucid,
Are you in the metro area? Which FD?

You're talking for the patients right? Not the FF's? I mean...seems like a lot of those cats might be jacked on Fentanyl most of the time anyway. That or an anoxic hit....either way.

Egg

 

[LucidResq]

I am in the metro Denver area. I believe the dept. is Castle Rock Fire Rescue, but again as far as I know this is a rumor.

 

[AZFF/EMT]

the army has been using them for a while.

 

[Ops Paramedic]

As per usual, we don't have them here, bummer!! Are these for use mainly in Peads?? It sounds like a good idea, becuase of the small dose (As per Rid), yet easy enough to get into the system (Without posing a threat to the airway) without having to do an IV.

 

[Katie]

i believe they're used for both adults and peds

 

[Ridryder911]

We only used them for pediatric, but I am sure they can be used on adults as well (dosages available?).

I liked them over other analgesics because they did not have the s/e of others.

R/r 911

 

[ccmedoc]

We only used them for pediatric, but I am sure they can be used on adults as well (dosages available?).

We use them for peds pain control as well. I think the "sucker" part starts them on their way and settles them down for the drug to take effect.

Far better than coming at them with needles right away. Makes IV access MUCH easier on all concerned, especially the parents seeing their child settled down.

I have seen them for adults, but usually the needle anxiety is not as great for them. Notice I said 'Usually'

without having to do an IV

I would still advise starting a lock with these patients..

Just an opinion

 

[Jon]

The brand I am familiar with is Actiq. Taking a look at my ePocrates listing, it lists the approved FDA dosing as being for "Breakthrough cancer pain, opioid-tolerant pt's." Their website http://www.actiq.com states that the product is ONLY for use in opioid-tolerant cancer patients with breakthrough pain, and that use with any other patients could be dangerous, because they could easily OD on the "sucker."

I know I've heard of concerns that pain-managment physicians (and other docs) are prescribing these to more and more patients who don't meet the manufacturer's dosing criteria.

Is there another brand, or are EMS services carrying Actiq? If they are, is this a liability concern because of a use other than the approved dosing instructions provide for? Could the FDA or even the manufactuer sue the EMS provider, EMS service, or EMS Physician?

I'm not trying to trash the idea... in fact, it isn't a bad idea, and if it provides pain relief in a reasonable manner, it actually might be a great idea... but keep the Narcan handy just in case.

Jon

 

[mikie]

I never heard of these, seems like a good idea.

However, it seems like something that would end up 'on the streets' -"officer, it's just candy!"

 

[Ridryder911]

I never heard of these, seems like a good idea.

However, it seems like something that would end up 'on the streets' -"officer, it's just candy!"

I doubt you will find them on the streets. You dispense them one at a time and observe them eating them (there not very big). The dosage strength is
minimal as well in comparison to other med.'s. Now, what is popular is Duragesic and Fentanyl patches. I have heard of them freezing them and "cubing" them. As well as "melting" them down and injecting the med.
Consequences is that Fentanyl is several times stronger than even Morphine Sulfate.

R/r 911

 

[MedicPrincess]

The sucker sounds like a great option. We carry Fentanyl, Morphine, and Toradol for our pain control options.

 

[Airwaygoddess]

Fentanyl use for Oncology

Not on th ambulances here but I have seen them used on th oncology floor for break though pain. Wonderful for pain control.

 

[LucidResq]

I doubt you will find them on the streets.

They are on the streets. Google "perc-a-pop" or "morphine lollipop" (incorrect, but most people on the street recognize morphine rather than fentanyl).

There have been some good points raised about the use of Actiq with kids, however.