Rainbow Fentanyl - JASE Medical

Fentanyl Follow up

Scroll down to watch the fentanyl documentary, a must watch video

A few weeks ago, I wrote about the epidemic of rainbow fentanyl that has hit the market and how dangerous this drug is. When properly used, such in end-of-life care, this prescription opioid drug can provide relief where other pain relievers aren’t effective. As a former home health and hospice nurse I would teach caregivers how to apply the medication loaded patch behind the ear, taking care to for the caregiver to not touch the inside of the patch. Back then, we were aware of how potent this medication was, and it was prescribed in only the most severe cases of pain.

Fast forward to now and this medication is now one of the worlds most dangerous street drugs. According to a press release from the DEA:

“Fentanyl is the single deadliest drug threat our nation has ever encountered,” said Administrator Anne Milgram.  “Fentanyl is everywhere.  From large metropolitan areas to rural America, no community is safe from this poison.  We must take every opportunity to spread the word to prevent fentanyl-related overdose death and poisonings from claiming scores of American lives every day.”

I wish I had better news to report, but I am starting to believe we are only seeing the tip of the iceberg. In just the past weeks:

This is such heartbreaking news, so many lives lost, so many families and loved ones torn apart from this drug.

Action plan:

In order to protect you and your loved ones from this onslaught of fentanyl that has reached every state and community in the US there are a few tips provided by the DEA on their website:

  • Those who encounter fentanyl are advised not to handle it directly and call 911.
  • The DEA has launched a fentanyl awareness page
  • National fentanyl awareness day was August 21, 2022 On this site are educational and tips to help identify and keep you and your family safe from fentanyl
  • Must watch video, Dead on Arrival, a documentary on the fentanyl crisis,
  • An educational website on illicit drugs, org
  • Dealers use social media to push their drugs. Be aware of this.
  • You can purchase Naloxone at any pharmacy that can reverse the effects of fentanyl and other narcotics, such as morphine. Please be proactive and have some on hand if there is any chance anyone you know may engage in illicit drug use.

- Brooke Lounsbury

Medical Content Writer

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Hand, Foot, Mouth Disease

Hand, foot, and mouth disease is often confused with foot-and-mouth disease (also called hoof-and-mouth disease), which affects cows, sheep, and pigs.

Humans do not get the animal disease, and animals do not get the human disease.

What is it:

Hand, foot and mouth disease can be spread by two different viruses, however it is most commonly spread by the coxsackievirus. It is highly contagious and is a common childhood illness. HFMD is common in children under the age of 10, but any age can contract it. You can contract the disease more than once, however the symptoms will be less severe.

The virus can sometimes spread to others for days or weeks after symptoms go away or if they have no symptoms at all (carriers of the virus).

How is it spread:

HFMD is most contagious during the first week when a person is sick.

This highly contagious virus is spread through contact with:

  • Nasal and throat secretions (saliva, drool or nasal mucus)
  • Fluid from scabs or blisters
  • Poop (not using hygienic bathroom practices)

Common signs and symptoms:

  •  
  • Sore throat.
  • Feeling sick.
  • Painful, blister-like lesions on the tongue, gums and inside of the cheeks. These lesions can lead to poor appetite or risk of dehydration due to pain when attempting to eat or drink.
  • A blister like rash on the palms, soles of the feet and sometimes the buttocks. The rash is not itchy. The blisters are usually small, oval, and white, and are usually not found on the trunk.
  • Fussiness in infants and toddlers.
  • Loss of appetite.
  • Symptoms usually last from 7-10 days after becoming infected.

 

How to treat:

Antibiotics do not work on viruses and are not given to children with HFMD. HFMD will get better on its own.

  • Tylenol or ibuprofen. Ask your care provider what they recommend for pain relief.
  • Be sure to offer liquids to prevent dehydration.
  • Do not squeeze or otherwise pierce blisters. The fluid contained in the blisters is highly contagious.

When to seek medical care:

If your child is unwell with a fever and a skin rash (small bright red spots or purple spots or unexplained bruises) that does not turn to skin-color (blanch) when you press on it, this may be a sign of meningococcal infection (see  Meningococcal infection).(This is a very rare occurrence)

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Are you Prepared for Fire?

The end of the summer brings dry weather and many areas at risk for wildfires. Many areas, including California, along with the disruption by evacuations or electrical blackouts, can bring many challenges that not just the fires bring. Home fires are of particular concern because they usually happen without warning, can occur during the middle of the night and can catch you off guard.

According to the National Fire Protection Association (NFTPA) :

  • More than one-quarter (26%) of reported fires in 2015-2019 occurred in homes. Even worse, three-quarters (75%) of civilian fire deaths and almost three-quarters (72%) of all reported injuries were caused by home fires.
  • During this five-year period, US fire departments responded to an estimated average of 346,800 home structure fires per year. These fires caused an annual average of 2,620 civilian deaths; 11,070 civilian fire injuries; and $7.3 billion in direct property damage.
  • Most home fires and fire casualties result from five causes: cooking, heating, electrical distribution and lighting equipment, intentional fire setting, and smoking materials.
  • Over the five-year period of 2015–2019, cooking was the leading cause of home fires and home fire injuries, while smoking was the leading cause of home fire deaths.

These are alarming statistics. Are you prepared and know what to do if fire hits your home?

Below are a few considerations for fire preparedness, the NFPA has excellent resources

  • Regarding smoke alarms and a safety plan: Check and replace your smoke alarms Develop a safety plan, how to evacuate your home and to make sure everyone has a meeting place. Practice this monthly.
  • Practice electrical safety around water. Electrical fires can start anywhere in the home at any time, especially if you live in an older home that hasn’t had the wiring recently inspected and upgraded. Along with the danger of an electrical fire is the risk of electrocution that extinguishing a fire can bring when using water.
  • Have fire extinguishers available in all areas of the home, especially the kitchen and garage areas. Learn from your local fire department how to use them properly. Have them refilled, check them at the same time you inspect your smoke alarms. Make sure you are using an extinguisher rated for your intended use. Also have an extinguisher in your auto, check it periodically also.
  • If a fire breaks out in a public area, such as a restaurant, nightclub, hotel , school, dorm or other area, always take mental note of where the exits are and how you would leave the building if a fire broke out
  • At risk groups such as elderly and disabled require a plan in place for their safe evacuation and safety.
  • Store gasoline and other flammables in a cool, dark place in containers designed for their contents.
  • Smoke inhalation can be deadly, especially with structural fires. The types of plastics and other materials can create deadly fumes. When exiting a burning building stay as low to the ground as possible. The fresher air is found there.

 

  • Teach children the dangers of fires at an early age. There are many resources on the internet and library that can help. NFPA has a good you tube video on fire safety targeted at children.
  • Keep flashlight, whistles, phone and other items near your bedside in case fire breaks out during the night.
  • Have a plan in place for your pets.

Take the time to implement and practice fire safety and practice with your family fire safety and prevention. It could very well save a life.

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Part 2, Common Back to School Illnesses

Last week we reviewed head lice, colds and flu and pinkeye. Today we will look at impetigo.

Impetigo

Impetigo is a skin infection caused by one or both of the following bacteria: group A Streptococcus and Staphylococcus aureus. It is the most common skin infection in the age 2-5 group. On occasion adults may become infected, especially if they have another skin issue or are recovering from a cold or other virus.

Group A Streptococcus (group A strep) causes many different infections. These infections range from minor illnesses to very serious and deadly diseases., such as strep throat, scarlet fever, cellulitis, rheumatic fever and more.

Staphylococcus aureus (S. aureus or “staph”) causes skin and soft tissue infections such as abscesses (boils), furuncles, and cellulitis. Most staph infections are not serious, however staph infections can on occasion cause bone, bloodstream, and pneumonia. Methicillin-resistant staph aureus (MRSA) is an antibiotic resistant staph infection is becoming more common.

How impetigo is spread

  • Impetigo is highly contagious and can be spread from skin-to-skin contact, like in daycare and school environments where children are in close contact with each other.
  • People with scabies or other skin infections or injuries that break the skin are at an increased risk of impetigo.
  • Sharing washcloths and towels,
  • Contact with sores and rash through personal contact (hugging, playground play)
  • Not practicing correct personal hygiene- by keeping sores and blisters clean and removing excess crusty material as it builds up.

Symptoms and diagnosis

Symptoms include:

  • Impetigo starts out as red itchy blisters and sores, that easily spreads when scratched.
  • The blisters are filled with yellow or honey-colored fluid and ooze and crust over. Rash that may begin as a single spot but spreads to other areas due to scratching.
  • Sores usually start on the face and lips and can spread, arms, or legs and other areas of the body.
  • Patches of impetigo on the body (in children).

Treatment

Both S, aureus and group A strep impetigo are treated either with an antibiotic cream or in the case of a severe infection an oral antibiotic.

Your care provider can guide you in the best treatment option available. They may want to take a sample of the bacteria on the skin to determine if you have impetigo, however visual observance is how it is usually diagnosed.

Impetigo can take weeks to clear up. If the rash spreads or does not get better (after a week or so) following treatment, contact your care provider for further guidance. You may need to try another antibiotic.

NOTE: Most impetigo is caused by group A strep

Most cases of impetigo are treated with a prescription antibiotic cream applied directly to the affected area(s). Only severe cases and cases that aren’t healing may need an oral antibiotic.

Be sure to keep sores clean by daily cleansing with mild soap and water and patting dry. Wash soiled washcloths in hot water and dry on high heat.  Apply prescribed cream once skin is dry.

It takes about 10 days for sores to appear after someone is exposed to group A strep. If an oral antibiotic is indicated for group A strep impetigo it is usually treated with Amoxicillin-Clavulanate (one of the antibiotics in the Jase case)

If an oral antibiotic is indicated for S. aureus impetigo, your care provider may prescribe doxycycline (one of the antibiotics in the Jase case) or another antibiotic if needed.

Complications of untreated impetigo

Rare complications include:

  • Kidney failure
  • Glomerulonephritis
  • Scarring

Prevention

  • Use a clean washcloth and towel each time you wash.
  • DO NOT share towels, clothing, brushes, and other personal care products with anyone.
  • Avoid touching sores that are oozing. If you do, immediately wash hands, wipe hands on towel and immediately put the towel in the washer or if using paper towels, discard in trash immediately.
  • Keep your skin clean to prevent getting the infection. Wash minor cuts and scrapes well with soap and clean water
  • Avoid using hot tubs or swimming pools to prevent spread of impetigo to other parts of the body

 

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Planning a Road Trip?

Travel plans over the Labor Day weekend? Do you have the fluids in your car topped off, the tire pressure checked, bags packed for the road? How does your first aid bag look – is it stocked and ready for emergencies you may encounter on your trip?

Preparedness doesn’t just stop at the home while we are out and about our usual day, from running errands to long distance travel, medical emergencies can happen anytime. Knowing what to do and having the necessary tools in the event of an emergency could be the difference between life and death.

Traveling solo in your vehicle presents challenges not encountered when using public transportation such as air travel and cruise ships. These types of travel have basic and advanced first aid and crew members who are trained to handle medical emergencies.

Whether you travel by motorcycle, car or RV medical emergencies can arise and there could be no one to help. Rural areas where there is no cellphone service, inclement weather preventing emergency personnel to respond are just a few need to manage an emergency on your own.

Getting ready for your trip

On the road you could encounter any number of different types of emergencies. From a car crash to a cardiac event to food poisoning from eating stale food from your cooler, the wide array of medical emergencies is almost endless.

  1. Planning and obtaining necessary supplies
  • Not only having medication and supplements packed, have on hand extra water for everyone in case of a breakdown. At least 2-16 ounce bottles of water per person is desirable.
  • If you have Jase cases for your family, be sure to bring them along. These medicines could prevent a costly trip to the emergency room if you or your family become ill on the road.
  • If anyone traveling with you is diabetic have juice or other sweet snacks in case of low blood sugar.
  • Have electrolyte drinks or mix for water in case of extreme heat and electrolyte loss
  • Keep warm blankets, towels, flashing flares and a well equipped first aid kit for the car.
  • Open and insect the contents of your first aid kit. Discard and replace any used, contaminated, or expired items in it.
  • Check your first aid medications. Do you have medication to stop diarrhea, nausea, vomiting, over the counter pain meds? Allergy meds? Bug repellant? Creams for burns? A warm blanket to prevent shock? Flashlights with batteries? A distress whistle if car ends up off the road and can’t be seen from the road? Shovel and gloves, a container of cat litter for traction if you find yourself on icy pavement and are unable to obtain traction is invaluable.
  • Make sure you have extra clothing and outerwear in case of inclement weather.
  • A physical map in case you are unable to navigate with GPS (GPS isn’t reliable in rural areas)
  • Let someone you know the route you are planning on taking and your estimated ETA. Contact them once you have arrived at our destination.
  • This is just a short list of items that you may want to consider when venturing out of town.

With a little forethought and planning you will arrive at your destination safely. Have a safe and fun Labor Day holiday!

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If no medical care is available-Do all members of your family have a Jase Case? Melissa Gilbert of Little House on the Prairie fame recently posted on Instagram that she had to go to the hospital. 2 days prior to an insect bit her arm. The bite had turned red,...

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Do you have an extra glucometer in your supplies? A chronic condition such as diabetes can be life threatening if our fragile medical supply chain is disrupted and medication or supplies to test are not available. Having adequate supplies- an extra glucometer with...

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