Wimmera ambulance volunteers accredited to administer fentanyl| Pain relief concern

TEN Wimmera ambulance volunteers have been accredited to nasally administer the strong pain-killer fentanyl in the past year.

Fentanyl is a schedule eight drug which is highly addictive and in overdose can cause unconsciousness and in some cases death.

Ambulance Victoria declined to confirm the exact location of the volunteers aside from confirming 10 volunteers across the Wimmera were trained.

Media reports earlier in the week highlighted Rainbow as an area where fentanyl-trained volunteers were based.

Across the Wimmera, there are ambulance community officers stationed at Rainbow, Kaniva, Donald and Patchewollock.

Fentanyl training is given to volunteers who are in areas outside a 30-minute response time range.

Secretary of the ambulance union Steve McGhie said the union had opposed the move 12 months ago and remained deeply concerned that volunteers with limited training could administer a drug which paramedics were not allowed to administer until they had completed a three-year university degree and 12 months of on-road training.

“It is highly addictive and highly dangerous and we felt that it was just not right,” he said.

Ambulance Victoria medical adviser Professor Stephen Bernard said the practice did not put anyone in the Wimmera at risk of overdose despite the relative inexperience of volunteers.

“The use of intranasal fentanyl by selected volunteer first responders has been providing effective and safe pain relief to people in rural and remote areas for more than a year,” he said.

“It is extremely helpful in the treatment of severe pain in patients in remote areas of the state as ambulances are en route.

“In the past 12 months there have been 54 cases involving the administration of intranasal fentanyl by ambulance community officers and community emergency response team volunteers without adverse incident.” 

But the union has disputed the claims, saying at least one incident concerning a three-year-old boy being treated for fractures in East Gippsland was under investigation.

“It is concerning and a safety issue for the community – with respect to the ambulance community officers because they do a terrific job,” Mr McGhie said.

He said the under-resourcing of ambulance services and poor response times in rural and regional areas had led to the move by Ambulance Victoria.

Prof Bernard said volunteers were given strict guidelines to administer the drug along with their basic training – a 96-hour course which achieved a certificate II in emergency medical service first response – and an eight-hour course in fentanyl administration.

“The intranasal delivery method is administered under strict protocol and has been proven to be a safe and effective method of pain relief,” he said. 

“Ambulance community officers and community emergency response team volunteers are trained to identify the side effects of intranasal fentanyl and implement treatment should they occur. 

“There has been no need for antidote to be administered.”

Mr McGhie said one of the main concerns he had with volunteers administering fentanyl was that they did not carry the antidote, the drug Naloxone, and if an overdose occurred the patient would have to wait for a paramedic to attend.

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