Drug overdose deaths in the United States have been rising at alarming rates in the past several years and will likely continue to do so. Prescription opioids as well as illicitly manufactured opioids play a large role in these deaths. These overdoses result in increasing numbers for first responder calls and responses to “person down” with presumed drug overdoses, many of whom are being pronounced dead on the scene. Almost all of these deaths are due to severe respiratory depression. However, many more of these potential victims are being resuscitated, or partially resuscitated, prior to first responder arrival on the scene by naloxone administration, either by family/friends or other bystanders.
The first responders, especially EMS, can be faced with several dilemmas and need to make rapid and well-informed decisions. Is the victim dead or do they need to be resuscitated?
Was this an accidental overdose? Was this a potential murder? Was it a potential suicide?
Many of these victims may display some of the presumptive signs of death upon EMS arrival. The victim might have been at the site, a cold room or in an alleyway or in the park and therefore be cold to touch. Many, even if still alive, will have markedly decreased respirations and on quick look may appear to not be breathing. They might display bluish discoloration due to hypoxia, or have stiff joints from being cold. Pupils may be dilated or constricted, depending on the type of drug used. In all cases, the EMS providers should be able to recognize the presumptive and definitive signs of death, and make an informed decision about resuscitative efforts.
All of these responses must be approached as crime scenes, with the primary focus being evaluation and treatment of the victim, but at the same time, paying attention to preserving the scene and all evidence. We are seeing in our area, many of the drug dealers being found, arrested and charged with murder. In order to get these dealers off of our streets, information has to be available in order for prosecutors to do their jobs.
The guidelines set forth by the American Institute of Crime Scene Integrity (AICSI) and the educational program offered by AICSI covers Drug Overdose Scenes and many other interesting and important topics. The e-learning programs offered by AICSI are CAPCE approved.
Go to aicsi.com to learn more about these important educational opportunities.