RACINE COUNTY — Nick Hempel remembers walking into an apartment and seeing a man face down on the kitchen table, as a result of an apparent overdose.
The man was unconscious. An overdose seemed likely but there were no needles in sight, said Hempel, division chief of EMS for the Racine Fire Department.
When responders lifted the man’s head, the drug use became apparent.
“The syringe was sticking out of his forehead,” Hempel said.
There are myriad dangers present when first responders, whether police or EMS, arrive at any emergency scene. Typically they are walking into unfamiliar territory.
With a recent influx of designer drugs, namely synthetic opioids, responders are now dealing with additional stress from more calls and a range of potencies in drugs.
Overdoses are becoming commonplace in Racine County and around the nation, according to Chris Eberlein, medical adviser for the southwest region of the Department of Health Services. And he sees increased wear on EMS personnel.
“The sheer volume of calls makes it difficult enough,” Eberlein said.“These patients are very sick and take a lot of time to care for. There are dirty needles. It adds a whole other layer to the job.”
On the scene
When responders arrive at the scene, safety is the primary concern for the patient and responders. For overdose scenes, the biggest concern is used needles.
“The needles may contain parts of the drug, and responders may accidentally take it,” Russell said.
Finding the syringe is a good thing for responders. The problems come when they have to play “find the needle in the haystack.”
If a scene is deemed unsafe for emergency personnel to enter, they cannot enter until it is made safe.
“Our safety is important as well,” said Dan Russell, assistant chief for emergency medical services at the Union Grove-Yorkville Fire Department. “We can’t help the patient if we get hurt.”
Once a scene is deemed safe, the responders enter and must be prepared.
“We’re working with minimal amounts of information in the area of EMS,” said Union Grove Fire Chief Tom Czerniak. “There is very little we are going to do for a person who has overdosed. We gather what info we can and try to keep the person breathing. You’re going to die if we don’t turn (the overdose) around.”
With so little information, it is difficult to determine the correct treatment to combat the effects of the illegal drugs. With drugs like Narcan, which is used to reverse the effects of opiate substances, the drug is usually harmless even if administered to a patient that had not taken an opiate substance.
A problem arises when responders have to administer drugs that may not react well with whatever the patient used. This has become more of an issue with the national influx of designer drugs. The chemical compounds are similar, but when mixed to create a drug cocktail, the effects increase.
“We have to be very careful with the drugs we administer because it could be drug-to-drug reaction,” Russell said. “We don’t know the chemical compound, and that leaves us in the position of darned if you do, darned if you don’t.”
Even with Narcan sometimes, there isn’t a guarantee drugs like it will have the same reactions.
“It’s important for responders to know that designer-drug users may not respond to naloxone in the same way a heroin user would respond,” said Barry Logan, chief of forensic toxicology at NMS Labs in Pennsylvania.
Wear and tear
Though responders deal with emergencies on a daily basis, it can wear on them. Depending on the situation, they differ in their responses to overdose-like incidents.
“You get two reactions,” Hempel said. “EMS people who are sympathetic — or the ones who get jaded and angered by it.”
No matter the instance, Hempel said that he and all responders will always provide care.
“In the perfect world, if people didn’t suffer from substance abuse or addiction, our jobs would be much easier,” Hempel said. “It’s easier to sympathize with someone who is having an epileptic seizure or a heart attack than someone overdosing.”
Racine County Sheriff’s Office Deputy Andrew Willis said he understands that it is an addiction and, no matter what, he and all responders will administer care.
“Is it something we like to do? No,” said Willis who is one of four drug recognition experts in the department. “We don’t like seeing that, but we are trained to save someone’s life.”
It is a tough situation for all involved.
“There is empathy for the person with the addiction,” said South Shore Fire Battalion Chief Jon Keiser. “It’s a sad situation. Addiction issues are tremendously difficult to deal with.”
Here to help
Despite the trials of emergency scenes, responders know the risks they face. Job No. 1 is to help the patient.
“Our primary function is to assess the patient and correct any life-threatening situation that we see,” Russell said.
Hempel said responders understand the tribulations that arise from drug addiction, and that it goes beyond initial care at times.
“I’ve sat on the floor with people that are crying their eyes out because they don’t know how to get the monkey off their back,” Hempel said. “No one sets out to get addicted. It’s sad that it happens.”