So, the saying goes. Experience is a harsh teaching because it gives the exam first and then the lesson.
In this particular case, a particularly painful lesson.

Police: Drunk Red Lion man grabs EMT’s testicles

A Red Lion man had a rather peculiar way of thanking an EMT who helped save his life Saturday evening, if charging documents are any indication.

Pennsylvania State Police allege that Aron Mack Smith, 24, kissed the arm and grabbed the testicles of an EMT more than 30 years his senior after being revived from a drunken stupor with naloxone, a drug used to revive people from overdoses.

First lesson. It’s never a good idea to place yourself in a position where you can’t escape from an advancing patient.

Second lesson. Narcan does not reverse the effects of alcohol. Nor does it reverse the effects of Marijuana.  So, there are two possibilities here. First young Mr. Smith was not unconscious because of narcotics, he was just drunk and stoned. He just happened to wake up as he was given the Narcan. The article doesn’t say how the Narcan was given, but general practice among paramedics who don’t know better is to start an IV and slam in 2mg IV. If Mr. Smith was on narcotics, that was likely to wake him up pretty quickly. Unfortunately, based on my experience from days gone by, it also tends to make patients wake up mean and looking to fight. Which seems to be the case here.

I, and most of the paramedics I worked with, stopped giving IV Narcan sometime back in the late 1990s. The first advantage of that is it removes one opportunity to get stuck with a needle from the call. Although we used a needle to give Narcan via the Intramuscular route, the likelihood of getting stuck with that needle was far less. Plus there was almost no blood in the needle when we were done.

After the naloxone was administered, “Smith became responsive within several seconds and was immediately uncooperative,” the document states, adding that he refused to comply with orders to get on the ground before he was eventually handcuffed to the ambulance bed. He was sedated after the testicle incident, the documents state.

Drunks like to fight too. Especially drunks that have been woken up and are surrounded by people in uniform. Alcohol does many things, but making people smarter is not one of them. Note that after going to the effort to wake Mr. Smith up, the paramedics then had to restrain him and give him a sedative.

Smith is being held in York County Jail in lieu of $20,000 bail. He faces charges of aggravated assault, public drunkenness and similar misconduct and two marijuana-related charges.

It looks like young Mr. Smith learned a lesson as well. Don’t get so falling down drunk that some concerned citizen decides to help out by calling 9-1-1. That, and don’t assault the people who are coming to help you. Then again, I have a feeling that Mr. Smith just might have a history of making unwise decisions.

While the article does not mention the name of the paramedic, rest assured that every EMS provider in York County, PA knows exactly who it was.

Narcan is a good drug, if it’s used correctly. Sadly, I’ve seen it used incorrectly by providers of all levels, including physicians. That’s a story for a different day.