LACONIA — Nowhere has abuse of heroin and other opiates been felt more keenly than at the emergency department of Lakes Region General Hospital, where 73 patients were treated for overdoses during the last six months of 2014 and, since the turn of the year, the pace has not slowed.
"These are very resource intensive patients," said Kendra Peaslee, director of Emergency Services at LRGH. who stressed that treating those who have overdosed places heavy demands on the medical and security personnel of the hospital, often at the expense of other patients requiring care.
An overdose of an opiate, whether from illicit heroin or prescription medication, attacks the part of the brain that regulates respiration, causing breathing to become slow and shallow. As breathing slows, levels of carbon dioxide in the body are elevated, further slowing and ultimately stopping the breathing and heart rates.
Peaslee said that when patients reach the emergency room the immediate priority is to restore their breathing. Those transported by ambulance have been administered Narcan, or naloxone, a medication that reverses the effects of the opiate, by emergency medical technicians. Others may be brought to hospital by friends, in which case Peaslee said that medical staff will administer Narcan in the parking lot.
Peaslee explained that once treated with Narcan, patients go into immediate withdrawal, which may prompt them to become restless, and violent. Dr. Fred Jones, medical director of the emergency department, recalled patients whose lives were saved turning on physicians and nurses to charge "you ruined my high" or "you just wasted my money".
Consequently, Peaslee said that at least three and sometimes four nurses are required to attend patients during the first 30 minutes after their arrival and added, "we almost always have security on hand. You can imagine," she continued, "what happens when we have a couple of trauma cases and a girl drives up with her boyfriend in the back seat barely breathing."
Bill Losefsky, chief of security, said that he has two full-time officers on duty 24 hours a day, seven days a week, at least one of whom is generally required to assist with overdose patients, especially those brought to the hospital by friends. He said that the clinical staff may order that a particularly difficult patient, who is deemed a danger to self or others, be placed on watch and confined to the hospital, requiring the presence of a security officer for "what could be hours, says or more than a week. I have half my staff watching one patient," he said.
Once a patient is breathing, clinicians take their medical history and monitor their vital signs. Peaslee explained that this process can be challenging with addicts undergoing the effects of immediate withdrawal, which may be accompanied by restlessness, nausea, vomiting, fainting and other side effects. "We're scrambling to get information," she said. "It's labor intensive and kind of a puzzle that takes more time and effort with these patients."
Peaslee said that patients usually remain in the emergency room, where their condition is monitored by a nurse, for two or three hours. Those she described as "straightforward" may be discharged home, some may be held overnight and others with complicating medical conditions may be kept longer. "The outcome varies on a case-by-case basis," Peaslee said.
At peak times, seven or eight nurses, one or two medical technicians and two physicians will be on duty in the emergency department, but Peaslee said that at 3 a.m. there may be only three or four nurses and one physician on hand. She said that patients present with overdoses at random times. "They always require a significant amount of our available resources, but they are incredibly taxing when our staff is lean," she said, adding that overdose patients often lengthen the waiting time required of other patients needing emergency care.
Before patients are discharged they are given advice about the nature of their addiction and what steps they can take to address it. "It happens every time," Peaslee said. "We always want to present the opportunity for recovery and steer them in the right direction," she said. She added that the clinical staff offers to connect patients with the appropriate social services and drug counselors and will follow-up with the patient.
Dr. Jones noted after patients' lives have been spared is an opportune moment to have a chat about the risks of substance abuse, encourage them to seek treatment and refer them to an appropriate facility. While the staff of the emergency room can spare lives for the moment, he noted, ultimate survival hinges on a successful regimen of treatment and recovery.
Last Updated on Tuesday, 17 March 2015 12:13
LACONIA — While there was some confusion yesterday, particularly where Veterans Square joins Beacon Street West, when downtown traffic was rerouted around reconstruction of the Main Street Bridge, Captain Matt Canfield of Laconia Police Department said "there have been no complaints and no accidents."
During the fourth and final phase of the bridge work the westernmost of the three spans that compose the bridge will be rebuilt, which requires closing the foot of Beacon Street West to traffic and routing southbound traffic to Pleasant Street and Main Street. Main Street. In order to provide access to the parking lot along Beacon Street West that serves the businesses on Main Street as well as offer southbound traffic access to Water Street Beacon Street West is open to two-way traffic for most of its length.
Officer Brandy Enis began directing traffic at Veteran's Square at 6:30 a.m. yesterday. The presence of the police cruiser and traffic cones led some motorists to conclude Beacon Street West was closed to traffic. "I saw the cruiser and the cones," said a woman shopping at Sawyer's Jewelry yesterday afternoon, "and though the street was closed. Now I'll just ignore that police car."
Enis said that apart from a tendency of some vehicles traveling westbound from Veteran's Square to enter the (now) northbound lane of Bacon Street West, traffic has moved smoothly. "It may take a few days for people to get used to it," she said. Unlike the intersection at Pleasant Street and Main Street, where striping and signage directs traffic north and south, the junction at Veterans Square and Beacon Street West has not been striped. Moreover, Enis was not only directing traffic through the intersection but also into the parking lot of the Bank of New Hampshire.
Canfield said that there are no plans to assign an officer to the location today.
The changed traffic pattern appears to have had no significant adverse effects on downtown merchants. At Sawyer's Jewelry, which has entrances on both Main Street and Beacon Street West, Jim Rogato said that the most significant impact was "rattling and rolling" from the jack hammers breaking up the concrete outside the store. "The floor was shaking," he said. Rogato said that no parking spaces have been lost and motorists can reach both sides of the store.
Despite the confusion at the north and of Beacon Street West, there was no appreciable effect on the lunchtime trade at Hector's Fine Food and Spirits. Randy Bullerwell of All My Life Jewelers, a mainstay of the downtown business community, said that he had a busy day and heard nothing from his counterparts along Main Street. Likewise, Nancy Brown, administrative assistant to the city manager, said that she had not fielded any calls about issues raised by the changed traffic pattern.
Last Updated on Tuesday, 17 March 2015 11:42
LACONIA — The Belknap County Convention Monday night approved a $26,823,694 budget which increases the net amount to be raised by 2015 property taxes by $1.3 percent. The bills will be passed on the 11 municipalities for collection.
The convention made only one change in the working budget it had approved last week, shifting $100,000 from the Finance Department budget to a newly created personnel management reserve budget line which gives the Belknap County Commission authority, with convention Executive Committee approval, to fill the now vacant county finance director position through either hiring a new person or contracting with an outside service provider to perform some of the functions handled by the finance office.
The change came after Rep. Guy Comtois (R-Barnstead) made a motion to cut $100,000 from the Finance Department budget, maintaining that since last week's departure of Finance Director Glen Waring it was time for the county convention to consider Commissioner Richard Burchell's plan to streamline county government by cuts in county administration.
He said that it was Burchell's position that the department could operate in the absence of a finance director and said that kicking the ball down the road on county government can't continue.
Comtois said that taxes in Barnstead will be rising by $2.50 to $3 a thousand after the school district budget is passed on Saturday and said some tax relief is needed.
Brian Gallagher (R-Sanbornton) said that while he was sympathetic to the burden being placed on taxpayers that it should be remembered that the finance director's position was created by the county on the recommendation of its auditing firm to deal with an embezzlement situation which had taken place when a former county administrator was also in charge of finances.
County convention Chairman Frank Tilton (R-Laconia) said it was his understanding that county commissioners were looking to turn to an outside agency such as Municipal Resources Inc. of Meredith to hire someone to run things until the finance position can be filled.
Commission Chairman Dave DeVoy (R-Sanbornton) said that commissioners were looking to establish a business model for the county but didn't want to make major changes without careful study of the options and consequences.
He said that he is also a property taxpayer in Barnstead — where he owns a pair of convenience stores — and while he sympathizes with Comtois's position, from the county's standpoint, the position needs to be funded.
Commissioner Hunter Taylor said that that it was misleading to try and have Belknap County follow the Carroll County model. ''They tried to slim down their administration but it didn't work and they're adding to their staff. Belknap County is very bare bone and lean. Give us time and don't tie our hands By cutting this money,'' he said.
Commissioner Burchell said the county has had a three-person finance office and he sees no need to outsource the finance director's workload, maintaining that one of the assistants in the office told him she was capable of doing the budget work.
DeVoy maintained that Burchell had placed people in the department in fear of being laid off and that people would ''say something just to keep their job.''
Tilton observed that the three new commissioners ''haven't exactly had the smoothest transition'' and said that should be allowed the time to do their own analysis of the county's staffing needs,
Convention Vice Chairman Herb Vadney moved to amend Comtois' motion by removing the $100,000 from the Finance Department budget and place it in a personnel management reserve account.
The motion passed by a 14-1 vote and the budget was later approved by a 12-3 vote.
Last Updated on Tuesday, 17 March 2015 02:22
LACONIA — Two young people lost their car Saturday morning after it burned in the parking lot at Jon's Roast Beef on upper Union Avenue.
City Fire Department Lt. Jeff Desrosiers said firefighters were at the Winni Dip at the nearby Margate Resort at 11:49 a.m. and were able to respond within minutes, however the car was engulfed in flames and couldn't be saved.
He said the owner of the car told him that he and a friend had just finished lunch at the China Bistro and were driving on Union Avenue when they smelled something burning.
Desrosiers said the two pulled over and opened the hood and something in the engine compartments was afire.
Descrosiers said the man told him he had just purchased the 2003 Saab and he didn't have insurance.
No one was injured and police and fire remained on the scene for about 45 minutes.
CAPTION: A Laconia Police officer captured this image of a car burning in the Jon's Road Beef on Union Avenue Saturday morning. (Photo courtesy of the Laconia Professional Firefighters)
Last Updated on Tuesday, 17 March 2015 01:26
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- Meredith Public Works actually spent more money keeping up with winter of 2013-2014
- 'Right-to-work' enjoys strong support on delegation
- Pair of heroin overdoses reported in city over weekend
- Trust established to own Bert Southwick farm
- No charges to result from fatal crash in August 2013