Responding to OD 04/21/2017

Seventy people attended the public forum.  Manager ‘The Works’ Shaun Hopkins a no show.

How painful was this presentation two EMS were present??

Ten’s of thousands in Ontario, Canada taught all the signs of breathing emergency (Drug OD), then trained to give chest compression’s. Empower laypersons what they think is a life saving technique they are eager to follow a clinicians instructions assaulting and murdering any breathing emergency patient. Increases mental and physical illness drug use and abuse, dysfunctional society.

‘Survival rates improving for out-of-hospital cardiac arrest patients’ http://www.ices.on.ca/Newsroom/News-Releases/2014/Survival-rates-improving-for-out-of-hospital-cardiac-arrest-patients
40,000 out of hospital cardiac arrest events each year Canada equals 15,000 in Ontario the only time you give CPR.  A lot less sudden witnessed cardiac arrests the only time chest compression’s only (read letter Heart & Stroke Foundation). Over a million people presented to Ontario hospitals per year with respiratory emergency. Chest compression’s for respiratory emergency is assault and murder, their heart is beating.  Rescue breaths ASAP your life depends on breaths.

Heart & Stroke Foundation Official site read my moderated comment AliasCPR https://youtu.be/Wy3eEES511E
Letter from H & S Foundation http://www.slideshare.net/GaryThompson11/heart-and-stroke-foundation-letter

April 21

Pamela Leece MD background April 21 Power Point follows

Leece P; Orkin A.et al ‘Development and implementation of an opioid overdose prevention and response program in Toronto, Ontario.’ CJPH 2013; 104(3)e200-4
My response above article https://jgarythompson.wordpress.com/2016/07/04/response-cjph-20131043e200-4/

Leece P; Orkin A. quote “Opioid users deserve the same high-quality, evidence-based practice as other patients.” JAMA 2013;309(9)873 http://jamanetwork.com/journals/jama/article-abstract/1660372

American Heart Association Guidelines Part 12.7: Toxic Ingestions http://circ.ahajournals.org/content/122/18_suppl_3/S829.full#sec-80
Toxidromes
“Practically every sign and symptom observed in drug overdose can be produced by natural disease, and many clinical presentations associated with natural disease can be mimicked by some poison.“
Response: Any of the hundreds of causes respiratory emergency mimic an overdose, rescue breaths ASAP. 2015 AHA guidelines refer you to the 2010 guidelines, suggest everyone follow what 2010 says.

Jan 9, 2017 Toronto’s Mayor John Tory Barbara Yaffe MD MOH Quoted drug OD issue “Ventilations (rescue breathing) most important”
Chest compressions still being taught!! Read comment box YouTube https://youtu.be/CycS5GeylbM

Quotes Mayor above press conference at 37 minutes “When you have a CRISIS…one thing that often stands in the way…different protocols people have…that they have protocols that are well agreed upon…this person didn’t tell me that…we have a different system here…this is what causes people to lose their lives quite literally.”
http://www.citynews.ca/2017/01/09/officials-meet-in-toronto-to-tackle-fentanyl-issues/

50,000 Ontarians are poisoned each year 28,000 children http://www.sickkids.ca/AboutSickKids/Newsroom/Past-News/2007/50000-Ontarians-are-poisoned-each-year-according-to-the-Ontario-Poison-Centre.html
May I suggest you teach people to save their lives instead of killing them all with chest compressions.

Lange [A gold standard of medical textbooks] ‘Poisoning and drug OD’ see page 1 ad fin item https://murdercube.com/files/Chemistry/Poisoning%20and%20Drug%20Overdose%20(4th%20Edition).pdf

Current edition Lange http://accessmedicine.mhmedical.com/content.aspx?

Ontario Poison Centre Step 2 BVM (Bag Valve Mask) = rescue breathing continue breaths all times. Start low dose naloxone  Better find the patient pre cardiac arrest ‘Street Opioid Resuscitation Recommendations’ For Pre-Hospital and Hospital Care
http://www.ontariopoisoncentre.ca/pdf/72759-Hopsitalguidelines_naloxone_v2.pdf Accessed March 12, 2017

Annotated medical info ‘Naloxone’ and my moderated comments #13-14 http://roguemedic.com/?s=Naloxone

‘Medscape’ Physicians most trusted site, my moderated comment https://jgarythompson.wordpress.com/2016/11/02/medscape-naloxone/

Naloxone ineffective Marcia L. Buck “Naloxone for the Reversal of Opioid Adverse Effects” Pediatric Pharmacotherapy. 2002;8(8)1-5 See bottom page 1 children kept alive five days respiratory assist. Doctors pumping massive doses Naloxone into children with no affect? Both toddlers probably would have woken up and started breathing on their own in the same time period without all the Naloxone.
https://med.virginia.edu/pediatrics/wp-content/uploads/sites/237/2015/12/200208.pdf

Thousands more case reports like this in the medical literature Naloxone ineffective. Women and children Naloxone ineffective kept alive rescue breathing. http://www.slideshare.net/GaryThompson11/case-reports-children-women-57633650

Ontario Pharmacist Association ‘How to kill your own Grandma & Mother her own child’ https://youtu.be/1a_SRu82jlw
https://youtu.be/aZ2SPcHUsvA Case report Jake @7:25 minutes. 4 breaths/min BVM = (rescue breathing ESSENTIAL) then Naloxone. Continue rescue breaths mandatory until next slide 14 breaths/min oximetry 97%

Complications chest compression’s a drastic measure only to be preformed cardiac arrest.
Atcheson SG, Fred HL. ‘Letter: Complications of cardiac resuscitation’ Am Heart J. 1975 Feb;89 (2):263-5 http://www.slideshare.net/GaryThompson11/complications-chest-compressions-64269212

James Roberts MD Cardiac arrest from respiratory emergencies a totally different animal than cardiac arrest from heart disease, chance of survival with an intact brain poor.
http://journals.lww.com/em-news/Fulltext/2011/10000/InFocus__Dissecting_the_ACLS_Guidelines_on_Cardiac.7.aspx

Dr. Ewy (The world expert chest compression’s only) phoned me “Gary don’t stop what you are doing”
Quote “Some doctors worry that bystanders can get confused and do only chest compressions in drug-overdose and drowning cases [any asphixia or poisoning etc] NOT TO BE GIVEN TO CHILDREN.”
http://www.azcentral.com/news/articles/2010/01/19/20100119cardiacdoc0119.html Email from Dr. Ewy https://aliascpr.wordpress.com/2016/06/25/email-dr-gordon-awy/

April 26, 2016 234 Doctors, other health care professionals and myself signed a letter to Ontario’s Premier Kathleen Wynne and Minister of Health Dr. Eric Hoskins about Ontario’s life threatening intervention.
See meaningless response from Premier https://www.linkedin.com/pulse/letter-kathleen-wynne-dr-eric-hoskins-gary-thompson

Scripture quotes rescue breathing https://aliascpr.wordpress.com/2016/10/23/scripture-rescue-breaths/

My letter ‘Flaws in Toronto’s Opioid Overdose Prevention Program’ EMN 2015; 37(12):31 With hyperlinks to Public Health Ontario’s training literature, and also the proper protocol.
http://journals.lww.com/em-news/Fulltext/2015/12000/Letter__Flaws_in_Toronto_s_Opioid_Overdose.14.aspx

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Note 6th slide Fentanyl Product  Monograph cf page 25 ‘Overdoseage’ quote “If the clinical situation warrants, establish and maintain a patent airway, administer oxygen and assist or control respiration as indicated, and use an oropharyngeal airway or endotracheal tube if necessary.”

Response: All those technical words mean rescue breathing for layperson essential, use a breathing barrier device. https://www.janssen.com/canada/sites/www_janssen_com_canada/files/product/pdf/durm08052014cpm2_nc.pdf

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My letter ‘Flaws in Toronto’s Opioid Overdose Prevention Program’ EMN 2015; 37(12):31 With hyperlinks to Public Health Ontario’s training literature, and also the proper protocol.
http://journals.lww.com/em-news/Fulltext/2015/12000/Letter__Flaws_in_Toronto_s_Opioid_Overdose.14.aspx

Leece P; Orkin A.et al ‘Development and implementation of an opioid overdose prevention and response program in Toronto, Ontario.’ CJPH 2013; 104(3)e200-4
My response above article https://jgarythompson.wordpress.com/2016/07/04/response-cjph-20131043e200-4/

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Samira Walji RN Power Point April 21

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Dr. Nicholas Etches Medical Officer of Health for Calgary district http://www.cbc.ca/player/play/895066691568/

EMS video https://www.youtube.com/watch?v=35lBf5s-iro

Darryl Gebien MD written, sung and recorded by Darryl ‘The Air I Breathe’ https://soundcloud.com/darryl-j-gebien

Lange [The gold standard of medical textbooks] ‘Poisoning and drug OD’ see page 1 ad fin item https://murdercube.com/files/Chemistry/Poisoning%20and%20Drug%20Overdose%20(4th%20Edition).pdf

Current edition http://accessmedicine.mhmedical.com/content.aspx?bookid=391&sectionid=42069814

All 70+++ references from 2015 AHA & ILCOR guidelines on opioid overdose quotes ‘rescue breathing only’
https://aliascpr.wordpress.com/2015/12/13/2015-ilcor-and-aha-references-opioid-od/

Your pet eats a poison or drug Veterinarian will give respiratory assist and any antidote, not torture them with chest compression’s only. Why would we allow this to our women and children?

Arrow with ‘Naloxone’ was an overlay pop-up done part way through the presentation.

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STOP CONFUSING CPR FOR BASIC LIFE SUPPORT RESCUE BREATHING ONLY FOR ANY OF THE HUNDREDS OF CAUSES BREATHING EMERGENCY IT’S NOT CARDIAC ARREST.

“You would think it brutal to withhold from the less capable [ANYONE] the air they need. The moment you begin discriminating against the less capable, you establish conditions that breed dissatisfaction and resentment: you invite envy, discord and strife.” Alexander Berkman “Life of an Anarchist” p.282

Not placing blame, change this protocol for the well being of all. Stop needless suffering

TPHinsideOFFICEFixed

Naloxone Nasal Spray 4mg

Phoned the FDA’s Pharmacologist quote “I agree Gary we do seem to have some problems” That’s putting it lightly Ontario, Canada out and out kills everyone with any breathing emergency, chest compression’s only taught. Junior grade school science ‘How the heart and lungs work’

Full handout give 30 people Feb 27, 2017 Toronto’s Kensington Market training session, grossly negligent information.  Have talked with QWCHC many times and other Managers etc. have talked with Public Health many times no change See photo below http://narcannasalspray.ca/pdf/NARCAN-Prescribing-Information-ca-en.pdf

CORRECT Ontario Poison Centre 2017 Step 2 BVM (Bag Valve Mask) = rescue breathing continue breaths all times. Start low dose naloxone ‘Street Opioid Resuscitation Recommendations’ For Pre-Hospital and Hospital Care. Better find any respiratory patient before cardiac arrest because brain death is what causes the arrest, lack of oxygen.
http://www.ontariopoisoncentre.ca/pdf/72759-Hopsitalguidelines_naloxone_v2.pdf Accessed March 12, 2017

Massives doses naloxone can be harmful Clinical opioid withdrawl scale. Massive doses Naloxone 4mg may put patient sever withdrawl needlessly
https://www.drugabuse.gov/sites/default/files/files/ClinicalOpiateWithdrawalScale.pdf

Shannon Riley RN lead OD issue forwarded my info all political parties April 13.  Wake up people anyone with any breathing emergency is being assaulted or murdered in Ontario.  Increases drug use and abuse dysfunctional society.

Shannon Riley April 13

Naloxone Spray

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Many health districts in Ontario, Canada have taught layperson’s all the signs of respiratory emergency drug OD, then trained them to give chest compression’s. Empower ten’s of thousands what they think is a life saving technique they are eagerly following a clinicians contraindicated life threatening orders. The protocol increases mental and physical illness drug use and abuse, dysfunctional society. Signs of drug OD can mimic any breathing emergency rescue breaths ASAP your life depends on breaths. Basic grade school science ‘How the heart and lungs work’

Jan 9, 2017 Toronto’s Mayor John Tory (knows his friends and family that never used a drug are being assaulted/murdered and said something) Mayor and Barbara Yaffe MD MOH Quoted drug OD issue “Ventilations (rescue breathing) most important”
Chest compressions still being taught!! Read comment box YouTube https://youtu.be/CycS5GeylbM

Quotes Mayor above press conference at 37 minutes “When you have a CRISIS…one thing that often stands in the way…different protocols people have…that they have protocols that are well agreed upon…this person didn’t tell me that…we have a different system here…this is what causes people to lose their lives quite literally.”
http://www.citynews.ca/2017/01/09/officials-meet-in-toronto-to-tackle-fentanyl-issues/

Correct per all medicine Dr. Nicholas Etches Medical Officer of Health for Calgary district http://www.cbc.ca/player/play/895066691568/

50,000 Ontarians are poisoned each year 28,000 children http://www.sickkids.ca/AboutSickKids/Newsroom/Past-News/2007/50000-Ontarians-are-poisoned-each-year-according-to-the-Ontario-Poison-Centre.html
May I suggest you teach people to save their lives instead of killing them all with chest compressions.

‘How to kill your own Grandma & Mother her own child’ https://youtu.be/1a_SRu82jlw
https://youtu.be/aZ2SPcHUsvA Case report Jake @7:25 minutes. 4 breaths/min BVM = (rescue breathing ESSENTIAL) then Naloxone. Continue rescue breaths mandatory until next slide 14 breaths/min oximetry 97%

Lange [A gold standard of medical textbooks] ‘Poisoning and drug OD’ see page 1 ad fin item https://murdercube.com/files/Chemistry/Poisoning%20and%20Drug%20Overdose%20(4th%20Edition).pdf
Current edition http://accessmedicine.mhmedical.com/content.aspx?bookid=391&sectionid=42069814

April 26, 2016 234 Doctors, other health care professionals and myself signed a letter to Ontario’s Premier Kathleen Wynne and Minister of Health Dr. Eric Hoskins about Ontario’s life threatening intervention.
See meaningless response from Premier https://www.linkedin.com/pulse/letter-kathleen-wynne-dr-eric-hoskins-gary-thompson

My letter ‘Flaws in Toronto’s Opioid Overdose Prevention Program’ EMN 2015; 37(12):31 With hyperlinks to Public Health Ontario’s training literature, and also the proper protocol.
http://journals.lww.com/em-news/Fulltext/2015/12000/Letter__Flaws_in_Toronto_s_Opioid_Overdose.14.aspx

Your pet eats a poison or drug Veterinarian will give respiratory assist and any antidote, not torture them with chest compression’s only. Why would we allow this to our women and children?

Scripture quotes rescue breathing https://aliascpr.wordpress.com/2016/10/23/scripture-rescue-breaths/

It’s a mental illness called Anosognosia a severe form of denial. Anosognosia is quite different than simple or temporary denial. It is not simply denial of a problem, but the genuine inability to recognize that the problem exists. Usually this is caused by brain damage and/or FEAR!

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.

Not placing blame, change this protocol for the well being of all. Stop needless suffering

Naloxone protocol April 4, 2017

My local Shoppers Drug Mart gave me the following information today April 4, 2017.  Told the assistant after reading the info “Let me talk to the pharmacist”  “Why are you handing out this info”  “Gary I have read the info you gave me months ago, they make me do it”  “Your a pharmacist and know about poisoning/drug OD it’s mandatory and no one makes you do anything”  Any sane person given this info should phone or write University of Waterloo or Public Health Waterloo and tell them stop and if they don’t go to the police and have them charged with murder.

Phoned U of Waterloo Pharmacy explained the handout and the signs are any breathing emergency patient needs rescue breaths ASAP their life depends on this.  Response “Wow will put you through to Professor the lead on the issue”  Be assured the staff person I talked with knows the info is wrong.  First class pharmacy school any poisoning/drug OD give breaths ASAP, not allowed in any lab not knowing this.  Left my contact info with the professor and told of my concerns”

One of my articles in the medical journals ‘Flaws in Toronto’s Opioid Overdose Prevention Program’ EMN 2015; 37(12):31 With hyperlinks to Public Health Ontario’s training literature, and also the proper protocol.
http://journals.lww.com/em-news/Fulltext/2015/12000/Letter__Flaws_in_Toronto_s_Opioid_Overdose.14.aspx

Your pet eats a poison or drug Veterinarian will give respiratory assist and any antidote, not torture them with chest compression’s only.  Why would we allow this to our women and children?

Toronto’s Mayor John Tory (knows his friends and family that never used a drug are being assaulted/murdered and said something) Barbara Yaffe MD Medical Officer of Health Quoted drug OD issue “Ventilations (rescue breathing) most important” Not chest compressions as tens of thousands have been taught in Ontario.
Chest compressions still being taught!! https://youtu.be/CycS5GeylbM  Read comment box YouTube

Quotes Mayor above press conference at 37 minutes “When you have a CRISIS…one thing that often stands in the way…different protocols people have…that they have protocols that are well agreed upon…this person didn’t  tell me that…we have a different system here…this is what causes people to lose their lives quite literally.” Drug OD can mimic any breathing emergency rescue breaths ASAP your life depends on this.
http://www.citynews.ca/2017/01/09/officials-meet-in-toronto-to-tackle-fentanyl-issues/

Correct protocol Dr. Nicholas Etches Medical Officer of Health for Calgary district http://www.cbc.ca/player/play/895066691568/

Poisons nor drugs did not magically change it’s chemical structure and started causing death sudden cardiac arrest.  Nor did humans evolve and we started breathing though an exo skeleton like cockroaches. 

Everyone read the fine print hyperlinks with references, it’s not rocket science.

U of Waterloo April 4th

Ref 1) http://harmreduction.org/issues/overdose-prevention/overview/overdose-basics/
Read their link ‘Perform Rescue Breathing or Chest Compressions’  http://harmreduction.org/issues/overdose-prevention/overview/overdose-basics/responding-to-opioid-overdose/perform-rescue-breathing/
Quote ” When someone has extremely shallow and intermittent breathing (around one breath every 5-10 seconds) or has stopped breathing and is unresponsive, rescue breathing should be done as soon as possible because it is the quickest way to get oxygen into someone who has stopped breathing. If you are performing rescue breathing, you are getting much needed air into someone’s body who will die without it. The difference between survival and death in an opioid overdose depends on how quickly enough oxygen gets into the person’s body.”

Ref 2) http://www.ccsa.ca/Resource%20Library/CCSA-CCENDU-Take-Home-Naloxone-Canada-2016-en.pdf
page 10 “one-way breathing mask”  Read all the references this article.

Ref 3) http://www.albertahealthservices.ca/info/page12491.aspx Alberta info next slide
http://www.albertahealthservices.ca/assets/healthinfo/mh/hi-amh-thn-kit-brochure.pdf

Ref 4) https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6423a2.htm
Quote middle first paragraph  “Since 1996, an increasing number of programs provide laypersons with training and kits containing the opioid antagonist naloxone hydrochloride (naloxone) to reverse the potentially fatal respiratory depression caused by heroin and other opioids.” Proportion of use paper not an indication of success.

Ref 3

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Region of Waterloo Public Health info

Waterloo 2008 p1

WaterlooScan2010-13

 

Aaron Orkin MD Overdose Treatment

I was at this conference common quotes from people with more authority then myself “Orkin is a dangerous sociopath”  Original power point here https://www.dropbox.com/sh/dhnvt2urjf3lc52/AADqExB7H-J2lE591k8RYev6a/Monday%20Feb%2022%20Sessions/Overdose%20Training%20and%20Naloxone%20Distribution.pdf?dl=0

See the only moderated comment on Heart & Stoke Foundation’s Official site. Post by AliasCPR same info as below https://youtu.be/Wy3eEES511E

Slide 1-2

Orkin, Aaron et al ‘Development and implementation of an opioid overdose prevention and response program in Toronto, Ontario.’ Can. J. Public Health 2013;104(3):e200-4

Response:  https://jgarythompson.wordpress.com/2016/07/04/response-cjph-20131043e200-4/

Slide 2 Question ‘The First Aid Paradox”

Response: Scripture quotes rescue breaths https://aliascpr.wordpress.com/2016/10/23/scripture-rescue-breaths/

Self evident truth anyone showing the signs of overdose proves heart is beating dying acute respiratory failure.

Slide 2 (fine print) ‘Guidelines Update: the Science of Changing Lives’ http://3mg34c37ntii24dmio2yy6o5.wpengine.netdna-cdn.com/wp-content/uploads/2015/10/2015-Guideline-Special-CircumstancesUpdate-Infographic1.pdf

Quote #5  “Trained providers should administer naloxone to respiratory arrest patients with suspected opioid overdose”

Response: Laypersons must follow standard medical practice to any respiratory emergency patient. Humankind has known since the invent of opium 5,500 years ago, overdose death you stop breathing. Per all medicine supply respiratory assist essential (rescue breathing) to all respiratory emergency patients.

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Slide 3-4

Financial
– None.
-Non-financial
– 2015 American Heart Association Resuscitation Guidelines opioid overdose writing group.

Aaron Orkin et al Part 10: Special Circumstances of Resuscitation
2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
http://circ.ahajournals.org/content/132/18_suppl_2/S501

Response:  All 70+++ references from 2015 AHA & ILCOR guidelines on opioid overdose quotes ‘rescue breathing only’
https://aliascpr.wordpress.com/2015/12/13/2015-ilcor-and-aha-references-opioid-od/

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Slide 5-6

The Opioid Epidemic

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Slide 7-8

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Slide 9-10

Slide 9 (see fine print hyperlink) http://www.overdoseday.com/wp-content/uploads/2013/07/Factsheet-Greater-than-the-Road-Toll-KE-FINAL-15-August-2013.pdf

Quote p.1 “Non-fatal overdose, where someone has stopped breathing, can lead to hypoxic brain injury, caused by a lack of oxygen to the brain. These brain injuries can cause coma, seizures and, in worst case scenarios, brain death. The long-term consequences of hypoxia depend on how long the brain is starved of oxygen. In severe cases, brain injuries from overdoses can leave people in a vegetative state.”

Response: “opioid overdose is a respiratory emergency, not a cardiac arrest until brain dead lack of oxygen”

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Slide 11-12

Response: That is an x-ray of pulmonary edema, under ventilate any respiratory emergency patient pulmonary edema can kill you days later. Perpetuating the fear of HIV/AIDS. Coughing image patients alveoli sacs ruptured (pumonary edema) now spewing blood and pus??
http://www.radiologyassistant.nl/en/p50d95b0ab4b90/chest-x-ray-lung-disease.html

cf. fine print hyperlink Gomes, Tara et al. “The burden of premature opioid-related mortality.” Addiction 2014;109(9)p.1482-1488.
http://pubmedcentralcanada.ca/pmcc/articles/PMC4171750/pdf/add0109-1482.pdf

Response: No direct mention cause of death

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Slide 13-14

Slide 14

Prevent overdose
Recognize overdose
Respond to overdose with:
– BLS [Basic Life Support rescue breathing italics mine]
– Naloxone

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Slide 15-16

Quote “First aid training for people who are likely to witness overdose”

Response:  First aid training can save the lives of anyone suffering a respiratory emergency.

50,000 Ontarians are poisoned each year 28,000 are children http://www.sickkids.ca/AboutSickKids/Newsroom/Past-News/2007/50000-Ontarians-are-poisoned-each-year-according-to-the-Ontario-Poison-Centre.html

2010 American Heart Association Guidelines Part 12.7: Toxic Ingestions http://circ.ahajournals.org/content/122/18_suppl_3/S829.full#sec-80

Toxidromes “Practically every sign and symptom observed in drug overdose can be produced by natural disease, and many clinical presentations associated with natural disease can be mimicked by some poison.“

Response: Any of the hundreds of causes respiratory emergency can mimic an overdose, rescue breaths ASAP. 2015 AHA guidelines refer you to the 2010 guidelines, suggest everyone follow what 2010 says.

Slide 16

Walley, AY. et al
‘Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis.’
BMJ. 2013;346:f174 http://www.bmj.com/content/346/bmj.f174

Quote p.1 “providing rescue breathing, and delivering naloxone”

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Slide 17-18

McAuley, A. et al ‘Exploring the life-saving potential of naloxone: A systematic review and descriptive meta-analysis of take home naloxone (THN) programmes for opioid users.’ December 2015;(26)12, Pages 1183–1188 http://www.ncbi.nlm.nih.gov/pubmed/26508033

Quote p.1184 “because of ethical concerns related to denying control participants access to a life-saving medication” “reverse opioid overdoses when properly trained” p. 1185 “The content of training interventions was similar across each study and largely comprised of training in recognition, prevention and management of overdose, including life support and naloxone administration” p. 1187 “However using naloxone does not always equate to saving a life as some people may survive without it” “Given the variability of these training characteristics between the studies included in this review we elected not to include any analysis which explored how they might mediate success or not. RCT-level research comparing different THN training structures to determine the most effective delivery methods should be prioritised.” “Therefore the PoU (proportion of use) should be taken literally, not implied as a proportion of success”

Slide 18

Angela K. Clarke et. al. ‘A Systematic Review of Community Opioid Overdose Prevention and Naloxone Distribution Programs’ Journal of Addiction Medicine January 2014 8(3):153-63
https://www.researchgate.net/publication/264004247_A_Systematic_Review_of_Community_Opioid_Overdose_Prevention_and_Naloxone_Distribution_Programs

Quote p.153 “Patients that overdose are in a life threatening situation that requires an immediate medical intervention” “…..respond correctly to witnessed opioid overdose?” P.155 “…appropriate responses to overdose events, such as contacting emergency medical personnel, instructions on rescue breathing…”

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Slide 19-20

Rebecca E Giglio, Guohua Li and Charles J DiMaggio Effectiveness of bystander naloxone administration and overdose education programs: a meta-analysis
http://link.springer.com/article/10.1186%2Fs40621-015-0041-8#/page-1

Quote p.1 ” Naloxone has been the standard treatment for overdose effects like respiratory depression, sedation, and hypotension in the emergency department setting for the past 3.5 decades…” p. 2 “…overdose response strategies, such as calling 911 or using rescue breathing.”

Slide 20

“If your teenager misused opioids, would you keep Naloxone in the house?”

Response:  Anyone can overdose Grandmother your child anyone!  Pet eats a poison or drug Veterinarian will give rescue breathing then antidote continue rescue breathing. Not torture them with chest compression’s. Why do we allow this to our women and children??

Case reports women and children Naloxone ineffective kept alive rescue breathing.

Buck, M. L. “Naloxone for the Reversal of Opioid Adverse Effects”  Pediatric Pharmacotherapy. 2002;8(8)1-5  https://med.virginia.edu/pediatrics/wp-content/uploads/sites/237/2015/12/200208.pdf

Quote bottom page 1 “The first case involved an accidental ingestion of 100 mg normethadone by a 1 year old. The patient was initially treated with multiple bolus doses of naloxone, but when respiratory depression recurred, an infusion of 0.04 mg/kg/hr was started. The infusion was continued for 2.5 days. The second infant, a 3 day old, received an inadvertent morphine overdose of 5 mg due to a dosing error while hospitalized. This patient was given 4 naloxone boluses, followed by an infusion of 0.16 mg/kg/hr. The infusion was continued for 5 days, during which repeated attempts to wean the infusion resulted in further worsening of respiratory function. In both cases, the patients were discharged without sequelae.”

Response: Ventilations kept these children alive, Naloxone ineffective.

More case reports Naloxone ineffective kept alive ventilations (rescue breaths).

Medscape  ‘Naloxone for the Reversal of Opioid Adverse Effects’ http://www.medscape.com/viewarticle/441915_4 Read my moderated comment This link has timed out video copied here  https://youtu.be/PX0HQuaNS_I

‘How to kill your own Grandma & Mother her own child’ https://youtu.be/1a_SRu82jlw
Part 1 https://youtu.be/aZ2SPcHUsvA  Case report Jake @7:25 minutes. 4 breaths/min BVM = (rescue breathing ESSENTIAL) then Naloxone. Continue rescue breaths mandatory until next slide 14 breaths/min oximetry 97%

 

Slide 19-20
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Slide 21-22

Response:  Common sense there is no evidence use Naloxone in cardiac arrest situation, heart not beating therefore no blood flow.  Patient has most likely suffered sever brain death.

Roberts, James R.  ‘InFocus: Dissecting the ACLS Guidelines on Cardiac Arrest from Toxic Ingestions’ EMN 2011; 33(10)16-18
http://journals.lww.com/em-news/Fulltext/2011/10000/InFocus__Dissecting_the_ACLS_Guidelines_on_Cardiac.7.aspx

Quotes “Don’t confuse post- or pre–arrest toxicologic interventions with the actual cardiac arrest event” “This quote from the guidelines says it all: “There are (still) no data to support the use of specific antidotes in the setting of cardiac arrest” from any toxin.” ” Pharmacologic insults are just so massive and normal metabolism and physiology so deranged that no mere mortal can make a meaningful intervention. The seriously poisoned who maintain vital signs in the ED have the best, albeit never guaranteed, chance of rescue from a modicum of antidotes and intensive supportive care.”  “In a patient not in cardiac arrest and following ventilation and airway control, naloxone may be considered. Because it essentially reverses respiratory depression and coma, the ED part of the opioid code is about finished when the endotracheal tube is placed [Rescue breathing stops complications and keeps patient alive italics mine]”

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Protocol increases mental and physical illness, drug use and abuse.  Loss of trust in medical profession, harm reduction and addictions councillors, dysfunctional society.

 

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What the heck “Don’t pay taxes!!”

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Rebecca E Giglio, Guohua Li and Charles J DiMaggio ‘Effectiveness of bystander naloxone administration and overdose education programs: a meta-analysis’ J. Urban Health 2003; Jun 80(2):291-301
http://link.springer.com/article/10.1186%2Fs40621-015-0041-8#/page-1

Quote p.1 ” Naloxone has been the standard treatment for overdose effects like respiratory depression, sedation, and hypotension in the emergency department setting for the past 3.5 decades…” p. 2 “…overdose response strategies, such as calling 911 or using rescue breathing.”

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‘Health Canada Statement on Change in Federal Prescription Status of Naloxone’ http://news.gc.ca/web/article-en.do?nid=1027679

Quote “training would be required for those potentially administering the drug”

Response: Rescue breathing is essential.

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Liberal MP’s bill proposes ‘Good Samaritan’ immunity during overdoses  http://www.cbc.ca/news/politics/mp-drug-overdose-bill-1.3454146

Quote “we need every tool in the toolbox and this is one of those tools that we could use”  “spending much of the rest of your life in a vegetative state” “come up with some new actions, some new activity, some new interventions.”

Response: Appropriate response essential  “rescue breathing essential”  “vegetative state severe brain hypoxia lack of oxygen” “intervention opioid OD has been know for over 5,000 years you stop breathing”

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Slide 36 nice list of breathing emergencies which mimic signs of drug OD

We should prevent
– Drowning
– Anaphylaxis
– Choking
– Snake Bites
– Hypothermia
– Cardiac arrest
Not treat it!

Response: The layperson is eagerly treating all the above with chest compressions.  Question Give chest compression’s only near drowned; Give EpiPen and chest compression’s;  Chest compression’s only choking; Give antivenin and chest compressions; Hypothermia and chest compression’s ad fin item breathing emergencies???

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breathing emergencies

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Protocol is for a sudden witness cardiac arrest only See below letter from Heart & Stroke Foundation

Dr. Ewy (The world expert chest compression’s only) phoned me “Gary don’t stop what you are doing”
Quote “Some doctors worry that bystanders can get confused and do only chest compressions in drug-overdose and drowning cases [any asphixia or poisoning etc] NOT TO BE GIVEN TO CHILDREN.”
http://www.azcentral.com/news/articles/2010/01/19/20100119cardiacdoc0119.html 

Email from Dr. Ewy https://aliascpr.wordpress.com/2016/06/25/email-dr-gordon-awy/ 

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Letter H&S Foundation 001

 

 

Board of Health 20/03/’17

EMN Dec 2015 Good

Link to above article which links to Public Health murderous teaching and the proper treatment any breathing emergency.  Rescue breaths simple logic heart does not stop till brain dead lack of oxygen chest compressions only just makes sure you stay dead. http://journals.lww.com/em-news/Fulltext/2015/12000/Letter__Flaws_in_Toronto_s_Opioid_Overdose.14.aspx

My deputation March 20, 2017 Read comment box YouTube https://youtu.be/uz7GBCZrRek

Jan 9, 2017 Toronto’s Mayor John Tory (knows his friends and family that never used a drug are being murdered and said something) Barbara Yaffe MD Medical Officer of Health Quoted drug OD issue “Ventilations (rescue breathing) most important” Not chest compressions as tens of thousands have been taught in Ontario.  Drug OD mimics any breathing emergency rescue breaths ASAP your life depends on this.
Read comment box YouTube Chest compressions still being taught https://youtu.be/CycS5GeylbM

Quotes Mayor Tory above press conference at 37 minutes “When you have a CRISIS…one thing that often stands in the way…different protocols people have…that they have protocols that are well agreed upon…this person didn’t  tell me that…we have a different system here…this is what causes people to lose their lives quite literally.”  Correct John anyone with any breathing emergency are getting this life threatening intervention, laypersons are eager to follow orders in the belief they are saving lives.

Darryl J. Gebien MD emergency physician also made a deputation.  Song written and sung by Darryl “The Air I Breathe” https://soundcloud.com/darryl-j-gebien

Canadian Red Cross phoned the next day March 21 quote “Gary you want to make a formal complaint?” CRC follow your mandate save lives.  

March 21CRC

Copy of information package handed out to all members BOH

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Correspondence from Doctor Morrison 

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SIGNS of CARDIAC & RESPIRATORY ARREST

Reference #26 2010 American Heart Association Guidelines Part 12.7: Toxic Ingestions http://circ.ahajournals.org/content/122/18_suppl_3/S829.full#sec-80

Toxidromes “Practically every sign and symptom observed in drug overdose can be produced by natural disease, and many clinical presentations associated with natural disease can be mimicked by some poison.“

Response: Any of the hundreds of causes respiratory emergency mimic an overdose, rescue breaths ASAP. 2015 AHA guidelines refer you to the 2010 guidelines, suggest everyone follow what 2010 says.

My letter Emergency Medicine News 2015; 37(12):31 ‘Flaws in Toronto’s Opioid Overdose Prevention Program’ Hyperlinks to Public Health Ontario’s training literature

http://journals.lww.com/em-news/Fulltext/2015/12000/Letter__Flaws_in_Toronto_s_Opioid_Overdose.14.aspx

My article Feb 17, 2017 Rogue Medic “We keep making excuses for solutions that are neat, plausible, and wrong. Why don’t we start acting like responsible medical professionals and do what is best for our patients?”

http://roguemedic.com/2016/12/narcan-by-everyone-does-not-seem-to-be-such-a-good-idea/

Thank you to Gary Thompson of Agnotology for linking to this for me. https://aliascpr.wordpress.com/2017/01/24/cpr-k-p-mcdonald-ems/

Go read Response: ‘What happens when drugs become too powerful for overdose kits’ https://aliascpr.wordpress.com/2016/12/20/response-what-happens-when-drugs-become-too-powerful-for-overdose-kits/

‘How to kill your own Grandma & Mother her own child’ https://youtu.be/1a_SRu82jlw

Part 1 https://youtu.be/aZ2SPcHUsvA

Case report Jake at 7:25 minutes. “4 breaths/min BVM = (rescue breathing ESSENTIAL) then Naloxone. Continue rescue breaths mandatory until next slide 14 breaths/min oximetry 97%”

Public Health can’t follow what their bosses said Jan 9, 2017 Mayor John Tory (knows his friends and family that never used a drug are being murdered and said something) Barbara Yaffe MD Medical Officer of Health quote drug OD issue “Ventilations (rescue breathing) most important” Not chest compressions as tens of thousands have been taught in Ontario. Drug OD mimics any breathing emergency rescue breaths ASAP your life depends on this.   Read comment box YouTube https://youtu.be/CycS5GeylbM

Quotes Mayor Tory above press conference “When you have a CRISIS…one thing that often stands in the way…different protocols people have…that they have protocols that are well agreed upon…this person didn’t  tell me that…we have a different system here…this is what causes people to lose their lives quite literally.” Yes John everyone with any breathing emergency is getting murdered in this province I know of many OD’s and non OD’s alike.

Your pet eats a poison or drug Veterinarian will give respiratory assist and any antidote, not torture them with chest compression’s only. Why would we allow this to our women and children?

Anosognosia it is a severe form of denial. Anosognosia is quite different than simple or temporary denial. It is not simply denial of a problem, but the genuine inability to recognize that the problem exists. Usually this is caused by brain damage and/or FEAR!

Agnotology the deliberate fomenting of ignorance and doubt, how they control the masses. Google @GaryCPR for more info

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Full article Download PDF next slide Roberts, James R. ‘Intranasal Naloxone for Prehospital Opioid Overdose’ EMN 2014; 36(7)4-6 http://journals.lww.com/em-news/Fulltext/2014/07000/InFocus__Intranasal_Naloxone_for_Prehospital.5.aspx

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Letter H&S Foundation 001

Consultation 001

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Ontario Poison Control Health

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Letters from Public Health Dr. Rita Shahin etc found comment box https://youtu.be/QhsDjmI9H9c

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U of Waterloo April 4th

Canadian PA

59 Minutes SAVE A LIFE

Street Works

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‘CPR’ K. P. McDonald EMS

K. Patrick McDonald 30 years as EMS author ‘Paramedic Heretic’ and ‘America’s Dumbest Doctors’  Scroll to page 182-5 shocking case report uxoricide (drug OD) by a Doctor and treatment for overdose any breathing emergency.

The following is costing the taxpayer a fortune many left with permanent brain damage, multiple organ dysfunction syndrome etc. that never used a drug in their lives.  Causing needless stress and creates a dysfunctional society.

Jan 23, 2017 my two moderated comments Patrick McDonald’s Blog. Patrick’s edit (Healthcare protocols need to) Plus he added a link Agnotology [deliberate fomenting of ignorance or doubt in society]        https://medicalmiscreants.com/2017/01/23/two-more-doctor-drug-pushers-locked-up-some-things-just-never-change/comment-page-1/#comment-55315

Jan 9, 2017 Press conference  Toronto’s Mayor John Tory and acting Medical Officer of Health Dr. Barbara Yaffe quote “Ventilations (rescue breaths) most important” for any of the hundreds of causes breathing emergency ASAP your life depends on breaths https://youtu.be/CycS5GeylbM

Finally after five years of teaching ten’s of thousands chest compressions only, still being taught!!  Mayor John Tory’s Facebook the overdose issue hyperlink
https://jgarythompson.wordpress.com/2017/01/16/torontos-mayor-tory-fentanyl-o-d/

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Photo 2017 Launch ‘First Aid for Mental Health’

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Signs Public Health Ontario has taught ten’s of thousands of layperson’s prove the heart is beating and could be any of the hundreds of causes breathing emergency.  Give rescue breaths ASAP their life depends on this.

•Can’t wake the person up
•Breathing is very slow, erratic or has stopped
•Deep snoring or gurgling sounds
•Fingernails or lips are blue or purple
•Body is very limp
•Pupils are very small

Don’t do the worst possible thing Public Health teaches

1) Shake at shoulders, Shout their name
2) Call 911 if unresponsive
3) Naloxone Inject 1 ampule (1cc. 0.4mg) of Naloxone into arm or leg muscle
4) Chest Compressions Push hard and fast on the centre of the chest
5) Is it working? If no improvement after 3-5 minutes, inject a 2nd ampule (1cc. 0.4mg) of Naloxone and continue with chest compressions until EMS arrives.

My letter Emergency Medicine News 2015; 37(12):31 ‘Flaws in Toronto’s Opioid Overdose Prevention Program’ Hyperlinks to Public Health Ontario’s training literature
http://journals.lww.com/em-news/Fulltext/2015/12000/Letter__Flaws_in_Toronto_s_Opioid_Overdose.14.aspx

James Roberts MD Cardiac arrest from respiratory emergencies a totally different animal than cardiac arrest from heart disease, patient is “F**Ked”
http://journals.lww.com/em-news/Fulltext/2011/10000/InFocus__Dissecting_the_ACLS_Guidelines_on_Cardiac.7.aspx

Dr. Ewy (The world expert chest compression’s only) phoned me “Gary don’t stop what you are doing”
Quote “Some doctors worry that bystanders can get confused and do only chest compressions in drug-overdose and drowning cases [any asphixia or poisoning etc] NOT TO BE GIVEN TO CHILDREN.”
http://www.azcentral.com/news/articles/2010/01/19/20100119cardiacdoc0119.html Email from Dr. Ewy https://aliascpr.wordpress.com/2016/06/25/email-dr-gordon-awy/

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Sign Toronto Public Health head office Feb 5, 2017  Chest compressions only

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Read the monographs that come with Naloxone Don’t do as Ontario, Canada teaches chest compressions that’s assault and murder.
https://jgarythompson.wordpress.com/2016/06/29/monographs-naloxone-opioid-od/

‘Medscape’ Physicians most trusted site, my moderated comment https://jgarythompson.wordpress.com/2016/11/02/medscape-naloxone/

Langes ‘Poisoning and drug OD’ see page 1 ad fin item https://murdercube.com/files/Chemistry/Poisoning%20and%20Drug%20Overdose%20(4th%20Edition).pdf
Current edition http://accessmedicine.mhmedical.com/content.aspx?bookid=391&sectionid=42069814

Heart & Stroke Foundation Official site read the only moderated comment https://youtu.be/Wy3eEES511E
Letter from H & S Foundation http://www.slideshare.net/GaryThompson11/heart-and-stroke-foundation-letter

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Feb 27, 2017 I took this training Toronto Public Health nurse just about had a coronary when I told her my name as she filled out the Naloxone prescription.

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Toronto Mayor Fentanyl Crisis

Get ‘ready’ to deal with a fentanyl crisis, Vancouver’s mayor tells John Tory

http://www.cbc.ca/news/canada/toronto/programs/metromorning/fentanyl-toronto-vancouver-plan-get-ready-1.3923960

Metro Morning Radio CBC interview Mayor Tory above hyperlinked article 

Quote Mayor 2:45 minutes “Obstacles … different lines of communication … different protocols”  One correct protocol OD rescue breathing Naloxone continue rescue breathing.  Not as shown in the last article found addendum Jan 5, 2017 ‘chest compressions.’ Naloxone has no role in the management of cardiac arrest.

At 5:15 minutes “overdose situation can be resuscitated”  Naloxone is not resuscitation it’s an antidote, rescue breathing is resuscitation and is essential.

Toronto to hold meeting Monday Jan. 9, 2017 to come up with a plan to deal with the deadly drug

Toronto Mayor John Tory says he offered help to Vancouver, which is in the midst of a drug overdose crisis, and he received some timely advice instead.

“Be ready” for fentanyl, Tory was told.

Fentanyl, a synthetic opioid, is behind an alarming number of deaths in B.C. In November 2016, four British Columbians died from drug overdoses each day. In that month alone, 128 people died, with officials saying an increasing number of the overdose deaths are due to fentanyl.

Tory said Vancouver Mayor Gregor Robertson gave him a warning.

“Be ready. That was the number one piece of advice that Mayor Robertson had for me,” Tory told Metro Morning on Friday.

“It hasn’t yet come. These drug patterns over the years come from west to east in Canada. It hasn’t really come here to the same degree as it has in Vancouver.”

 

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My video out-take above photo with comments   https://youtu.be/zUO2TeeKC1E

Toronto police seized more than three kilograms of fentanyl last year, compared to a third of a kilogram in 2015.

Paramedics in the city administered 161 doses of naloxone — an injectable opioid overdose antidote — last year compared to 109 doses in 2015 and 110 in 2014.

“The number of paramedics now carrying naloxone has increased per the Ministry of Health in Ontario as have the protocols for administering it which may impact the current and historical statistics,” said Kim McKinnon, spokesperson for Toronto Paramedic Services, in an email to CBC News.

Anecdotally, front line workers are seeing more opiod overdoses amongst their clients in the community, according to Toronto Public Health.

Robertson told Tory that there isn’t much Toronto can do to help Vancouver but it can help itself by developing a strategy about how to deal with fentanyl now.

Tory plans to meet Monday with several municipal groups to draft a plan to deal with the drug, which far stronger than heroin.

“If you think about those numbers you just recited, four people a day, if that was going on with regards to a disease, like a SARS-type thing that we experienced many years ago, or even what we have seen with pedestrian traffic deaths, we would be saying, ‘Well, we’ve got to do more than what we’re doing,'” Tory said.

Monday meeting’s will build on work already done by Dr. Barbara Yaffe, the city’s medical acting officer of health, and Coun. Joe Cressy, who runs the city’s drug strategy. The meeting will look at the status of the problem and develop an action plan for Toronto.

Not confined to the west

“It’s one of those things that I think can sneak up on you,” Tory warned.

Robertson told Tory the fentanyl problem has spread from drug addicts to more recreational drug users and the crisis has deepened because of the inadequate treatment facilities for people with addiction issues.

“People are losing their lives,” Tory said. “This is not confined to the West.”

The meeting on Monday will include representatives from the Ontario coroner’s office, Toronto Police Service, Toronto Paramedic Services, Toronto Public Health, community groups, community service providers and the Centre for Mental Health and Addiction. It’s being hosted by public health officials.

“I want us to be ready if it comes east,” he said.

Jan 5, 2017 photo Toronto Public Healths head office incorrect ‘chest compressions’ “Inadequate oxygenation not inadequate Naloxonation”

http://www.theglobeandmail.com/news/national/toronto-moves-to-tackle-fentanyl-overdoses-before-city-reaches-crisis-point/article33508739/

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