On Tuesday, April 21, 2015 7:46 PM, "Shahab, Saqib HE0" <Saqib.Shahab@health.gov.sk.ca> wrote:Dear Mr Thompson

Thank you for your voicemail, e mail and links. At present SK does not have a THN (Take Home Naloxone) program and if SK was to develop one, training materials related to that would use the best information and evidence regarding that including when and how to administer Naloxone and additional appropriate interventions as required to support airway, breathing and circulation.

Thank you once again for flagging your concerns“Backwards all medicine says rescue breaths then you may give Naloxone, continue rescue breaths until patient breaths adequately on own. Circulation means dysrhythmia or cardiac arrest (brain dead lack of oxygen) requires Advanced Cardiac Life Support methods beyond the scope of laypersons.Coma patient can keep alive till Emerg Dept rescue breathing only” @GaryCPR

SincerelyDr Saqib Shahab FRCPCGovernment of SaskatchewanChief Medical Health OfficerMinistry of Health, Population Health Branch3475 Albert St, Regina SK S4S 6X6E mail: sshahab@health.gov.sk.caTel:   306 787 3220 From: Gary Thompson [mailto:jgary.thompson@mail.utoronto.ca] Sent: Tuesday, April 21, 2015 2:43 PMTo: Shahab, Saqib HE0 Subject: Re: News article April 18

Dr. Shahab:

Read with grave concern your quote of April 18 "A key feature of the take home program is training users' family or peers to recognize signs of overdose so they know when and how to administer the antidote, perform CPR compression's and call 911" http://www.thestarphoenix.com/health/Opiate+antidote+kits+possible+Sask/10983748/story.html I hope this does not mean chest compression's only?  Contraindicated for any respiratory emergency patient. Read all moderated comments AHA & ILCOR Opioid overdose response education https://volunteer.heart.org/apps/pico/Pages/PublicComment.aspx?q=891Response to Emily Oliver (awaiting AHA moderator)"....use of naloxone into their education programs. More research is needed regarding educational effectiveness..."

Do we need more research on opioid poisoning resuscitation protocols?  Clinicians see opioid poisoning daily in a clinical situation. Terminally ill are kept "comfortable" to wit OD narcotics. Cause of death acute respiratory failure. European Resuscitation Council Guidelines for Resuscitation 2010 Section 8.b Poisoninghttp://resuscitation-guidelines.articleinmotion.com/article/S0300-9572(10)00441-7/aim/

 Opioids“Opioid poisoning causes respiratory depression followed by respiratory insufficiency or respiratory arrest. The respiratory effects of opioids are reversed rapidly by the opiate antagonist naloxone.” Modifications for Advanced Life Support“There are no studies supporting the use of naloxone once cardiac arrest associated with opioid toxicity has occurred. Cardiac arrest is usually secondary to a respiratory arrest and associated with severe brain hypoxia. Prognosis is poor.” Agnotology is the study of culturally induced ignorance or doubt, particularly the publication of inaccurate or misleading scientific [medical] data.  Agnotology focuses on the deliberate fomenting of ignorance or doubt in society.http://issuu.com/garythompson81/docs/agnotologynote.docx Not placing blame, change this protocol of Public Health Ontario.  Have talked with all these clinicians many times in person, they live in a state of pure guilt. Please reply Best WishesGary Thompson718-77 Finch Ave EastToronto ONM2N 6H8647-864-6609@GaryCPR