Narcaid
Emergency Alert Bulletin

Date: 24 November 2000

Nature of the Alert

2CB - class A drug related to Ecstacy is appearing on the club scene. Known as 'Nexus', 'Spectrum' or 'Bromo'.

Appearance? Red pill or white power. In 'pure' state it is effective at 10-25mg doses and duration is about six hours.

Specific Medical Dangers

Gives hightened:

• visual imagery
• body awareness
• tactile sensitivity

Similar medical dangers as for Ecstacy.

Additional Information

Full name@ 4-Bromo-2, 5, - Dimethoxyphenethylamine. So far, in UK, 2CB has usually been found in drug seizures as a mixed forulation wiht the similar drug MBDB - white tablet with dollar/pound motif.

Pager No: 07666 783825

Narcaid is a project, which provides specialized drug awareness training for ambulance personnel and other emergency care practitioners. Its aim is to thereby facilitate the competent management of drug related emergencies.

Narcaid was founded in 1998, as a voluntary agency in response to the drug awareness needs of first aiders. It subsequently evolved into a training facility for professional ambulance personnel. For five years this ‘pilot project’ developed expertise and built a research base. From this came E.C.O.D.A- Emergency Care Orientated Drug Awareness. This targets the information shown by our research to be most helpful in the pre-hospital care environment, designed to maximize access, retention and application. Training in ECODA is unique to this project.

Membership of our ECODA Unit includes a distance learning package, on-line information and update service and membership of the research and advocacy project. The training programme is subject to an ongoing accreditation procedure and is considered suitable for continuing professional development. We are in the process of producing a clinical handbook.>

Narcaid is a member of the UK Harm Reduction Alliance. It has a steering committee or advisory body composed of professional medical personnel, drugs workers and teachers. They help ensure the training programme is up-to-date, relevant and effectively delivered. From June 1993, the project will run in association with Trafford Substance Misuse Services, part of Bolton, Salford and Trafford Mental Health NHS Trust. By so doing we will be able to utilize NHS resources and keep fees to a minimum.

PHILOSOPHY AND PURPOSE

We believe in the sanctity of human life. Drug use brings risks to life and health and we seek to minimize these on the basis that the using patient has the right to expect the same quality of care as any other. We are equally committed to the welfare of the medics who treat them. To this end we seek to provide the support they need to care for the using patient in a way, which respects the needs and vulnerabilities of both parties. We believe in the need for ongoing research into the effective management of drug related emergencies in pursuit of improved outcomes for medics and patients. We seek to present the views, experiences and needs of ambulance personnel, in this respect, before relevant government and professional bodies.

CONTACT DETAILS

Project Manager Ms. Jayne Irlam, B.A. (Hons), RGN.
30 Henshaw Street,
Stretford,
Manchester,
M32 8BT,
England.
Telephone: 0161-864-1199
Mobile: 07742 567113
Message pager: 07666 783825
E-mail: Jayne@narcaid.com

ECODA UNIT PROSPECTUS

Research, information and training in Emergency Care Orientated Drug Awareness in association with Trafford Substance Misuse Services.

TRAINING PROGRAMME

This is a distance learning programme divided into two parts. Each part is designed to take approximately six months to complete but students are allowed to work at their own pace. Part one, the generic programme, provides a fundamental knowledge of how drugs work and its focus is on more commonly encountered substances. It is suitable for those who wish to improve their confidence in everyday practice. Part two, the specialist programme, provides a more extensive understanding of drug related incidents. It enables students to gain confidence when dealing with more demanding presentations.

Successful completion of each part leads to a certificate and students will need to attain a part one certificate to progress to part two. It is intended that refresher courses will be available for graduates.

ECODA differs from traditional drug awareness in that it is specifically designed for the emergency environment. It highlights the knowledge that is needed and excludes that which is not. Research is used to target relevant content and teaching methods are designed to make the material memorable. The primary result appears to be a significant increase in practitioner confidence.

It should be noted that the Narcaid training programme is designed to teach drug awareness; it is not a medical skills course.

CURRICULUM Part One - The Generic Programme

Neurology
- Introduction *

Pharmacology 1
- Introduction *

Toxicology
- Introduction *

Drug Classification and Differential Diagnosis *

Drug Awareness (compulsory subjects)
- Alcohol *
- Heroin *

Psychology 1
- Understanding self-harm/parasuicide

Drug Awareness (compulsory subjects)
- Pharmaceuticals 1
      Paracetamol *
      Benzodiazepines (diazepam, temazepam) *

Psychology 2
- Management of disorientated, distressed or aggressive patients

Drug Awareness (compulsory subjects)
- Introduction to stimulant overdose *
      Amphetamine sulphate

Part Two - The Specialist Programme

Drug Awareness (compulsory subjects)
- Pharmaceuticals 2
      NSAIDs (aspirin, mefenamic acid) *
      Tricyclic and SSRI antidepressants (amitriptyline, prozac) *
      Beta-blockers *
      Iron poisoning *

Psychology 3
- The psychology of substance misuse

Drug Awareness (optional subjects)
- Ecstasy
- Methamphetamine
- Anaesthetic dance drugs (GHB)
- Anaesthetic dance drugs (ketamine)
- Hallucinogens (LSD)

Pharmacology 2
- Polydrug (multiple drug) use and interactions *

High Risk Presentations 1
- Paediatric emergencies *

Drug Awareness (compulsory subjects)
- Cocaine/crack *
- VSA (volatile substance abuse) *

* Assessed subjects (there is also some case study evaluation)

ASSESSMENT

Each module is usually sent by post although students can opt to submit material online. There are a number of questions at the end of each assessed module. Students submit their completed answer paper, which will be marked and returned along with the following module. The majority of the course is subject to multiple choice assessment with some case study evaluation. Topics of primary importance are assessed whilst others may be self-directed study or reading modules. Many of the assessed modules also have optional self-directed study materials to consolidate understanding. Experienced tutor support is available throughout the training period.

INFORMATION RESOURCE PACK

This pack contains details of useful web sites/online facilities. It should enable students to pursue information and assist them in keeping themselves updated. It includes a street language 'lexicon' to aid in the translation of patients' drug related 'slang'. It also contains some additional training materials.

MEMBERSHIP OF THE RESEARCH AND ADVOCACY PROJECT

This explains how our research to date has explored the challenges inherent in drug related emergencies in order to identify and meet training needs. Students are encouraged to contribute to the database in a way which defines them as proactive in developing a unique body of expertise. This is achieved by utilizing information from submitted case studies.

Narcaid's advocacy role is concerned with presenting findings before relevant government and professional bodies.

CLINICAL HANDBOOK

A series of laminated sheets encapsulating elements of the course materials is under construction. It will be available to graduates in a small, portable clip folder. This is designed as a memory or revision aid. It will focus on information most useful in an emergency, such as the signs and symptoms of illegal drugs and their chief medical dangers.

ELIGIBILITY

Admission to the unit is open to emergency care practitioners such as emergency medical technicians, paramedics, A and E nurses and medical staff. Practitioners in training are also eligible. Evidence of field of employment is required with each application.

ECODA was, however, designed with the pre-hospital care environment in mind and may be most suited to the needs of professionals working therein.

MEMBERSHIP OF ECODA UNIT - FEES

Many students should find that their employers will consider financial assistance, e.g., through such facilities as individual learning accounts. Cheques for full payment of fees should reach us not less than 28 days prior to commencement of training and should be made payable to Narcaid. Training departments can be invoiced by ourselves. In this case we should be notified of the authorization to invoice and the relevant address. Start dates for both programmes will be the 21st of each month, commencing 21/7/03, until places are filled.

Project manager Jayne Irlam is a registered general nurse and a member of the RCN Accident and Emergency Nursing Association. She is employed as a drug worker by Trafford Substance Misuse Services and is a member of DrugScope and the Association of Nurses in Substance Abuse. She has previously worked in adult education and belongs to the RCN Education Forum.

Jayne worked for several years as a divisional nursing officer and trainer/examiner for St.John Ambulance. She has a paramedic assist (advanced EMT) certificate and continues to gain pre-hospital care experience with Emergency Training Limited.

She founded Narcaid in 1998 and has continued to manage the project.

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