This summer, Damian Feldman-Kiss (IMP Class of 2022) led a research project evaluating a recent trial intervention meant to support individuals with lived/living experience of substance use that work on the frontlines of overdose response efforts in Victoria and the Lower Mainland.
Damian Feldman-Kiss (IMP Class of 2022)
The vast majority of overdose deaths in BC involve illicit opioids like fentanyl. However, there have been increasing reports of illicit substances containing both opioids and benzodiazepines. The opioid antidote naloxone has no effect on the sedation caused by benzodiazepines, making it difficult for first responders to manage overdoses involving mixtures of these drugs.
Pulse oximeters are small, portable devices that non-invasively measure an individual’s pulse rate and blood oxygen levels. When incorporated into the management of an overdose, pulse oximeters have the potential to provide clarity and aid decision-making by demonstrating the need for and effectiveness of resuscitation efforts. Although this device is commonly available to other healthcare workers, experiential workers—persons with lived/living experience of substance use who support people who use drugs—often do not have the same access, despite being at the forefront of harm reduction and overdose response efforts in BC.
So, earlier this year, the Peer to Peer project provided pulse oximeters to experiential workers at two pilot sites. Then, Damian, under the supervision of Zahra Mamdani and Dr. Jane A. Buxton of the Harm Reduction program at the BC Centre for Disease Control (BCCDC), conducted a series of qualitative interviews with experiential workers to investigate if and how the devices were providing the support they needed.
“I think the most exciting findings are that pulse oximeters aid in decision-making during interventions (such as when/if/how long to give rescue breaths and when/if to administer naloxone). They also improve competencies like communication, collaboration, and professionalism among experiential workers. They increase their confidence and save time,” he says. “We also found that pulse oximeters have the potential to decrease unnecessary contact, which is especially important during the COVID-19 pandemic as physical distancing is key to curb transmission.”
Anita Weng (IMP Class of 2021)
Although the authors found a few challenges associated with the device—such as false readings—they found that, overall, pulse oximeters are useful tools to supplement overdose response initiatives. They recommend increased access to pulse oximeters and adequate training for experiential workers across BC.
The authors also found that pulse oximeters have a calming effect on the clients. “This may lead to better outcomes by encouraging clients to adhere to monitoring recommendations by experiential workers,” Damian says.
As part of the research project, Damian also collaborated with Anita Weng (IMP Class of 2021) and Sophie McKenzie at the BCCDC to develop an educational document for experiential workers on how to incorporate pulse oximetry into overdose response. This document includes information on how to deal with false readings.
Damian presented the project at the 2020 BCCDC Research Symposium, and his evaluation report was recently published on the BCCDC website. His next steps will be working with the Harm Reduction program to prepare a manuscript for publication.