Park rangers at the New River Gorge National River are now carrying intranasal naloxone rescue kits, thanks to the foresight of park staff and a partnership between West Virginia University and the West Virginia Department of Health and Human Resources (DHHR).
Ms. Kathy Zerkle, a river ranger and emergency medical coordinator at the park, is training other rangers on the use of the rescue kits in the event of an overdose incident. Her 20 years of experience as a nurse at the Summersville Regional Medical Center have given her a unique perspective as a park ranger. When approached by Chief Ranger Mr. Duane Michael, Ms. Zerkle was eager to take the lead on the training initiative.
“An overdose is traumatic not only for the loved ones of the victim but also for other park visitors and our officers and rangers. There’s nothing worse than being there and not being able to do anything,” said Ms. Zerkle.
In April, Zerkle reached out to WVU to inquire about training opportunities. She participated in a “train-the-trainer” program through the West Virginia Office of Emergency Medical Services and is now permitted to train other New River Gorge rangers how to administer the naloxone. Zerkle visited the WVU Injury Control Research Center (ICRC) in late May to retrieve the rescue kits and held her first ranger training session in early June.
In the last decade, there have been five overdoses in the park – none of them fatal. For a park that receives more than a million visitors annually, being prepared for all types of emergencies is a top priority, says Chief Ranger Michael.
“We have to be prepared to respond to a wide range of emergencies,” said Mr. Michael. “Even if the naloxone is only used once in three years – and we save someone’s life – it’s worth having. Still, it’s a tool we hope we never have to use.”
Some parks within the National Park Service have emergency medical services (EMS) programs that allow for the use of intravenous naloxone. These parks are typically more remote and may not have a strong EMS network surrounding the park. To use intravenous naloxone, rangers are minimally trained at the emergency medical technician (EMT) and paramedic levels. Because New River Gorge National River is a fairly accessible park that enjoys the benefits of a local network of paramedics and firefighters, rangers there are minimally trained at the emergency medical responder (EMR) level and therefore not authorized to administer intravenous naloxone. However, under the direction of the park’s medical director, local protocols are being developed to allow rangers to carry and administer the intranasal naloxone.
“At the core of their responsibilities, rangers are out every day patrolling the park roadways, rivers, and trails to keep visitors safe and protect park resources,” said Mr. Michael. “They’re typically the first responders to arrive at a medical emergency. With the additional naloxone training, rangers will be able to utilize the rescue kits in emergency situations where every second counts.”
The WVU ICRC, in collaboration with the West Virginia DHHR’s Bureau for Behavioral Health and Health Facilities and Bureau for Public Health, has supplied the New River Gorge staff with 25 intranasal naloxone rescue kits as part of its inaugural statewide distribution program launched in February 2017.
“The distribution program has provided resources needed to support the creation of dozens of new programs in West Virginia police and fire departments, local health departments, opioid abuse treatment and recovery programs, harm reduction programs, and other organizations,” said Dr. Robert Bossarte, director of the ICRC and associate professor in the WVU School of Medicine. “We simply hadn’t considered our national parks and their use by individuals using opioids. We are grateful that the park officials brought these risks to our attention and that we could supply the New River Gorge National River staff with these life-saving kits.”
Housed in the WVU School of Public Health and supported by the Centers for Disease Control and Prevention, the ICRC focuses on research and public awareness around motor-vehicle-related injuries, falls among the elderly, occupational injuries and violence, traumatic brain injury, suicide and self-harm, and unintentional drug overdoses and poisonings, among other topics. The intranasal naloxone distribution program is just one of many initiatives that the ICRC and WVU are undertaking to combat the opioid epidemic in West Virginia.
WVU School of Public Health Dean Jeffrey Coben, is co-chair of the University’s Substance Abuse Task Force, a cross-disciplinary group of key stakeholders focused on encouraging, supporting, and coordinating research and outreach activities across WVU.
“As a land-grant institution, WVU is committed to serving the Mountain State and applying our research and expertise to meet the needs of our citizens,” said Dean Coben. “The goal of the Substance Abuse Task Force is to bring together potentially disparate efforts among our faculty and researchers to ensure a comprehensive approach to helping West Virginia and the nation deal with the opioid epidemic.”
Ms. Zerkle already sees the benefits of partnering with WVU.
“Without WVU, there is no way we would’ve been able to get our rangers trained in naloxone administration, purchase the necessary supplies for the kits, purchase the naloxone, and have all the correct documentation in place to have a successful program,” said Ms. Zerkle. “We wouldn’t have been able to do this without the wonderful help from the ICRC.”WVU