This case study will discuss Amphetamine use and misuse in the community setting, the impact of the substance use and misuse on contemporary paramedic practice and provide a guideline for the patients using this substance and the community in dealing with this issue. | Contents Introduction3 Body3 Amphetamines3 Case Analysis4 Case Remedies5 Conclusion6 References8 Introduction There is lot of expanded scope roles in the field of medical, nursing and paramedical which is emerging globally. This has given the health workforce many opportunities and allowed them to work in different environments (Bls, 2009).

These expanded scope roles gives a chance to the practitioners to apply skills which they were never trained on. Even for paramedics who have advanced emergency care skills need to put in a great deal of effort when it comes to working in rural areas and small town areas where there are no proper medical clinics). The reason being the size of the town, difficulty in employing and retaining health professionals, less health issue cases to attend to which can lead to risk of de-skilling due to which they rely on volunteers or sole paramedics in emergency services.

There is involvement of town’s community with other health organizations to carry out the paramedics services efficiently. Few of the activities done as rural or small town expanded scope of practice are getting the community involved, emergency response, extending scope of practice and primary health care. The paramedics play a vital role in providing medical attention to the emergency cases. They follow a set of rules and guidelines and provide emergency care and transport the patient to a medical facility or treat them on the spot if they have enough resources. The paramedic service is the xtended care and also works to ease the burden of the emergency departments from low priority patients who could be attended and treated safely at home (Bledsoe et al. , 2010). Patients have an access to a tailored care and if required it can bring in other health professionals who are appropriate to serve their needs. This essay discusses about a small town whose medical services mainly depend on the only paramedic in town. This essay discusses a case of the male patient who had behavioral changes due to misuse of drugs and how the paramedics would function to provide the necessary treatment.

Body Amphetamines Amphetamine is the drug considered for the case study; the affects of the drug on the patient is analyzed and necessary treatment provided by the paramedics. The amphetamine was first synthesized in 1887 by Lazar Edeleanu, a Romanian chemist. This new compound was found to cure asthma (Rasmussen, 2009). Since then there has been lot of research done on it and finally in 1932 the corporate pharmaceutical company Smith, Kline & French recognized that it can be used to relieve variety of ailments.

Amphetamines activates parts of nervous systems, the effects similar to adrenalin are produced at the synaptic sites of brain which causes heart and body systems to work at a faster rate (Drugtext, 2010). In addition, amphetamines have peripheral sympathomimetic actions, producing a rise in blood pressure and inhibition of gastrointestinal motility (Rang & Dale, 2007). These actions can lead to depression due to stimulation of those respective systems in the body. Amphetamines get assimilated in blood stream very fast which gives a rush of feelings.

The mood is elevated as body releases the reserved stored energy from the body (Egetgoing, 2011). The person who takes the drug exhibits if taken in milder dosage, symptoms such as hyperactivity, increased sensitivity to light and sounds, mood swings, irritability, sudden showing of anger or short temperedness, timidity etc. This drug makes a person physically and mentally charged up to begin with. However, once all the energy in the body reduces it leads to side effects such as restlessness, nervousness, agitation and many other side effects.

The drug acts on the central nervous system and any decrease in the supply of the drug in the body then causes symptom such as palpitation, hyperhidrosis, nervousness, blurred vision, agitation, sensitivity to light etc. The drug has its own benefits too in the medical treatment. Amphetamines are prescribed by doctors for various medical purposes such as appetite control for weight loss programs, narcolepsy and hyperactivity disorders. The main use of the drug is that it suppresses hunger, if administered by an experienced physician in mild doses.

This drug has several side effects similar to any street drug and is safe to use only as prescribed by a physician. The misuse of the drug poses greater threats to the general public and medical fraternity alike. The disadvantages of the use of drug far overweigh the advantages of controlled usage in medical practices. The drug is normally used in the form of pill or tablet. However, the drug can also be injected. The report discusses a case in which a patient suffers from ADHD and is prescribed Dexamphetamine; it discusses the affects and how it is dealt with by the paramedic.

Case Analysis This report discusses the case of a 20 year old male patient, Ben. He belongs to a small town and has been using intravenous drugs and has been suffering infective endocarditic with mitral vegetations and has also been diagnosed with onset adult ADHD which has affected his behaviour and led to violent outbursts. Ben was already suffering from ineffective endocarditic which is an infection of the endocardial surface of the heart which restricts the white blood cells reaching the valves of heart via bloodstream.

This can damage heart valves and infections can spread to other parts of the body. He then suffered from ADHD which is a problem with inattentiveness, over-activity, impulsivity, so overall his nervous system and immunity was severely affected. The doctors have prescribed dexamphetamine to control his ADHD. Medication for ADHD does not cure the diseases instead it relieves symptoms when consumed (Lawrence et al. , 2011). The reaction of the medications varies on different people so it should be carefully monitored.

The medications are more effective if it’s combined with other types of treatment simultaneously such as counseling, behavior therapy and relaxation techniques. Some of the alternative treatments include dietary interventions, Interactive Metronome training and chiropractic medicine. Ben is suffering from many diseases and the prescribed drug dexamphetamine is a type of stimulant which is a common type of medication prescribed for such disorder. Stimulants help increase dopamine levels in brain which is a neurotransmitter associated with body’s movement, motivation and attention (Cherry, 2007).

The reaction of such medications can increase concentration and focus. But it also comes with side effects such as feeling restless, irritability, mood swings, loss of appetite, dizziness etc. Dexamphetamine is the dextrorotatory isomer of amphetamine molecule which is the reason for the beneficial and recreational effects (Mydr, 2011). As discussed earlier amphetamines have lot of side effects though it gives a momentary boost to the body. If it’s consumed without the knowledge of dosage; it can create a toxic reaction which can last for weeks and leads to exaggeration of effects (Cherry, 2006).

In case of Ben the medication was prescribed by the doctors but there is a possibility he might have consumed wrong dosages since the medicine gives an adrenaline rush and gives a feeling of elation and confidence. The drug is also considered as party drug (a. k. a MDMA or ecstacy), which Ben could have also gotten his hand on from elsewhere. The over consumption of this drug might have brought on a behavioral change in Ben and initiated all the side effects and made him have more mood swings.

Ben could have consumed more doses in a day ignoring the prescribed dosages which the paramedic could not keep a track off. Thus drug abuse can have a negative impact on the patients and the society. Some of them are parents, whose untimely deaths lead to their children being in care of relatives or in foster care. Drug abuse is a social menace. Many social, economical, legal and healthcare issues arise due to drug abuse. Drug abuse also puts extra and unnecessary burden on paramedics.

Paramedics are forced to attend emergency conditions of drug abuse while the time could be dedicated to emergencies arising out of natural disasters, accidents and other such involuntary emergency conditions. As such; drug abuse is best dealt by controlling the use of the drug by spreading social awareness and by involving volunteers in the society to spread the message of unhealthy outcomes of drug abuse. Case Remedies Ben is suffering from ADHD so was prescribed dexamphetamine which consists amphetamine molecules and controls the symptoms of the disease but it also has lot of side effects (Lawrence et al. 2011). Ben must have not followed the dosages prescribed by the doctor and was facing lot of behavioural changes as well as mood swings, causing worry among the local people. The paramedics exhibit a more comprehensive multidisciplinary approach. The approaches of the paramedics in the small town are emergency response to incidents or in support of volunteer services, provide clinical care in out – of- hospital or institutional settings and engaging the communities. It has an advantage of attending the patient faster than the hospitals in urban areas.

Another significant strength of paramedics is that it gets social and political support from the public, volunteers and health care professionals who work with paramedics and this reduces the efforts to deal with various stakeholders as in local hospitals. Thus paramedics ensure that pre-hospital care provides patients an efficient and quality care (Cherry, 2006). The social workers and older aged on the other hand, support the cause of paramedics by observing the patients treated and rehabilitated for drug abuse.

These elderly neighborhood volunteers can keep an eye of these treated patients for drug use and alert the paramedics when abnormal behavior of these patients is observed. Being a paramedic I will see to it that Ben is examined regularly and keep a record of all the medications prescribed to him. His behavior has been irregular after he has been on dexamphetamine medication. So there is a need to examine his activities often. I convinced few people from the town who came across Ben everyday to volunteer and provide information about his bnormal behavior and activities. These volunteers at community level were asked to call the emergency number so the paramedic can attend to Ben when he is in pain or feeling abnormal. So when these volunteers call on the emergency number to report the abnormal conditions of Ben such as restlessness, difficulty in breathing etc the paramedic rush to the site. At the site I would first diagnose the conditions of Ben and would rate it as normal, risky, critical or emergency so that necessary action can be taken.

Once Ben is back to normal I would record the details of his condition, give advice of treatment and recovery plan to both Ben and an someone who can keep an eye on him. Ben also has severe mood swings and gets violent and angry at times I would try arranging a counselor who can deal with the situation. Depending on the severity of the condition of Ben I would either shift him to local clinic or if it’s critical shift him to the nearby town for emergency procedures. If the condition is not severe I will examine the reasons if it’s other than drug abuse then would administer treatment and admit him to local clinic .

If it is a case of drug abuse, I would refer Ben to rehabilitation centre after getting treated at local clinic or in the nearby town. Thus the treatment will help Ben to be stable and get well sooner. Conclusion The small towns have better healthcare services these days. The paramedic healthcare plays an important role in rural areas. The paramedics have sound knowledge to deal with different situations in the rural areas. Since the rural areas do not have medical services available all the time paramedics help a lot.

The paramedics work with the communities, volunteers and various health organizations which gives them more flexibility. If necessary the paramedics attend the patients in the ambulance which is well equipped and can treat almost all the major and emergency health problems (Cherry, 2007). This report discussed about a male patient who was prescribed a medication for his disease which brought behavioral changes in him. The report talks about how the author of this essay as a paramedic deals with the situation and prove the efficiency of the paramedical healthcare. Thus paramedics rovide extensive pre-hospital care. References Bls (2009), Emergency Medical Technicians and Paramedics, viewed on 06 October 2011 http://www. bls. gov/oco/ocos101. htm Bledsoe B, Porter R, Cherry R(2010), Essentials of Paramedic Care Update, Second Edition, Prentice Hall Cherry R (2007), Success for the Paramedic, Prentice Hall Cherry R (2006), Drug Guide for Paramedics, Second Edition, Prentice Hall Canning P (1998), Paramedic: On the Front Lines of Medicine, Ivy Books Drugtext (2010), Amphetamines, viewed on 06 October 2011 http://www. drugtext. org/library/books/recreationaldrugs/amphetamines. htm

Egetgoing (2011), Drug and Alcohol Information- Prescription Amphetamines, viewed on 06 October 2011 http://www. egetgoing. com/drug_rehab/prescription_amphetamines. asp Lawrence R, Smith M, Segal J (2011), ADD/ADHD Medications, viewed on 06 October 2011 http://helpguide. org/mental/adhd_medications. htm Mydr (2011), Dexamphetamine, viewed on 06 October 2011 http://www. mydr. com. au/medicines/cmis/dexamphetamine-tablets Rasmussen N (2009), On Speed: The Many Lives of Amphetamine, First Edition, NYU Press Rang, HP; Dale, MM; Ritter, JM; Flower, RJ. (2007). Pharmacology (6th edition), Churchill Livingstone, Sydney.