So, I need someone with real medical knowledge to advise me

[Commander Truestar]

Hi, I have a really weird one here.....
One of my players has come up with the most bizarre idea for a "bad guy kidnap kit"....

His idea is....get a micro-sample of fentanyl along with a NARCAN injector.
He believes the team can some how place the fentanyl where the target....and only the target will ingest it, or where they can inject it(A la Hawkeye injecting Frank Burns with a sedative in the TV show MASH)...

Then, when the target "dies", they could hope to move in and apply the NARCAM before the death is in fact fatal....
This way, they can take down dangerous targets without having to fight them

Now, all that assumption aside....
Does anyone have an idea how one would calculate the proper dosage based on...
.....body mass
....metabolism
....method of ingestion/injection....

His character is Medical-2, so he claims his character would have that knowledge and I'm like....

I can wait until they try and pull it and have some people with the target the whole time....or, have someone see the target drop and call local law enforcement.

But, I'd rather say, I consulted with someone medically trained and they said "FRAK NO!!

 

[TamsinP]

Not medically trained, but I was a technician in the Pharmacology department of a medical school and had to know a decent amount about pharmacology/toxicology.

The character would have a general idea about the dosage in a clinical environment, but wouldn't have the specialist knowledge of toxicology needed. Do the party have access to the target's medical records to know the body mass and metabolism? Most of the cases of medical workers who have killed patients using various drugs have shown that they massively overdosed some of their victims. It's generally suspected that some of their earlier attempts probably used too little and the victim survived.
The character would certainly know how to find out, but that information may be in restricted access databases for obvious reasons. Even if they can find out, they'd then need to somehow administer it - it's a reasonable assumption that the target is in a position where they know that attempts could be made to kidnap or kill them and will have taken precautions (bodyguards, food and drink scanned for toxins, broad spectrum pre-antidotes, etc, etc, etc).
If they want to go down that route, I'd suggest the following tasks need to be successfully completed (assuming they can obtain the drug and the NARCAN):
1) Obtain the target's medical records (which may be incomplete, out of date or otherwise inaccurate)
2) Access restricted medical databases to obtain the toxicology data (may be inaccurate, especially for an ancient drug)
3) Correctly calculate the dosage for chosen method of administration
4) Somehow get the drug to the target
5) Be in a position to apply the NARCAM

 

[whartung]

Well, I have no medical background, but since NARCAN is design to counter things like a Fentanyl overdose, you can probably be a bit loose on the required amounts. I can't see any scenario where you any amount enough to cause incapacitation isn't enough to be potentially lethal and likely needs immediate attention no matter what, so the snatch team is going to have to be very close by no matter what.

That said, I think this technique has a pretty high disregard for the safety of the snatch victim.

 

[Commander Truestar]

@whartung
Especially when there are safer routes to take, like using Tranq rounds....right??
I just want to tell this character I consulted with someone who has a fully trained clue rather than saying "No" out of hand

 

[McPerth]

I'm not too expert with fentanyl, being more used to petidine (Demerol^R in US, IIRC) or morphine, but the doses of opioids are mainly by body mass (petidine is 1-1.5 mg/kg, morphine 1/10 of this, counting ideal weight if overweight, as it does not distribute on fat).

Overdoses produce apnea (abscence of breathing), but are quite easy to treat with naloxone (NARCAN). be it spray for the nose or injected (subcutaneous or intravenous) as long the lack of oxygen has not yet stopped the heart (several minutes). OTOH, you don't need to reach the level of breath stopping, just to make him dizzy enough as to be incapacited...

The main problems I see in your plan are:

• I'm not sure how effective is oral Fentanyl (as I said, is one of the opioids I have less experience with). In any case, oral drugs are quite variable in absortion, depending on many factors, so the response may be quite variable.
• The effect of opioids may vary depebnding on the patient, mostly if they have develpoed tolerance of some kind, taht would require quite more dose, or their hepatic and metabolic function.
• Naloxone has short half life, so the overdose may restate in about 90 min if not careful
• Of course, if the victim takes other meds, they can interfere

In general, if I had to incapacite someone for a short time, I'd rather use a taser, as it's more relaible, though you plan may work, though many situations may interfere with it.

 

[coliver988]

@whartung
Especially when there are safer routes to take, like using Tranq rounds....right??
I just want to tell this character I consulted with someone who has a fully trained clue rather than saying "No" out of hand

I face some similar issues: players on a high-tech world so let's make up some SF thing, such as tranq rounds which are a known Traveller thing and assumed perfectly safe vs a potential death.

Of course my characters pick up a lead pipe to bonk someone, despite having a stun gun that he refuses to take with him afraid of getting pulled over by the cops (and not only that, decided against an actual stun gun [where my image is the type 1 phaser from ST:TOS] and picks a shotgun that shoots beanbags. What part of SF are they just not getting?)

Why running Traveller with gamers who don't regularly play Traveller SF (Star Trek, Star Wars, etc where there is a well-known set of technical constraints and ideas vs Traveller where each world is so very different) is harder than it should be (to me at least).

Good luck with the drug overdose method of taking down a bad guy though!

 

[Condottiere]

This is science fiction, so I see a significant advantage and disadvantage.

You can waive a tricorder in the general direction of the recipient, and that can scan body mass, likely metabolic rate, and anything that would be related to the successful outcome of the premeditated medication.

However, assuming it's relatively human, genetic drift could skew the results, despite presumably having access to extensive databanks on biology.

I would assume inhalation would be quickest, though I hear using rear entry point works as well.

 

[gchuck]

Use the scanner route. Turn off the bells and whistles, and just walk by and scan said bad guy.

Anonymous
(I don't want to called in as an accessory!)

 

[punkrabbitt]

As a referee, I would allow this. Because the player(s) put some thought into this and wanted to do something different than "there's one, set to stun."

 

[Spinward Scout]

I think the little SuSAG book had information like this.

There was also a Spies and Assassins book, if I remember right.

A long time ago.

 

[Hame]

Nice summary McPerth. I'm also no expert on Fentanyl, but I reckon you hit the main points.

Fentanyl can be given orally, typically for buccal administration in palliative care settings, but that introduces a more variability with onset and dosage for this scenario. Administering it intravenously is tricky with unwilling subjects. Opioids such as Fentanyl can be given intramuscularly [like a blow-dart], but then the onset of effect, duration and peak dose are more variable. Also not ideal for this situation. For additional context the 2002 Moscow theatre hostage situation saw the use of a gas that many Western experts suggested included the use of a gaseous form of Fentanyl. Worth reading about for some additional information and ideas.

In general, yes, using an opiate in a high enough dose will incapacitate a person and then naloxone can bring them back. But you do have to repeat the naloxone dose if the duration of effect for the opiate is longer than that of naloxone. These people are "narc'ed", but no-one with EMT, nursing or medical training would see them as "dead". If the dose is so high that the respiratory centres are depressed and the person becomes apnoeic [not breathing] thus appearing dead to the untrained [but still have a pulse]; then you only have a few minutes before brain cells start dying. Shortly after that they lose their pulse/have a cardiac arrest and are dead, needing naloxone and full resuscitation.

From memory Medical-2 is good for a medic, but not good for a nurse or doctor. Maybe they provide a nice high dose of Fentanyl causing apnoea, but are too slow with the naloxone, don't resuscitate and the target is properly dead...

 

[Spinward Flow]

From memory Medical-2 is good for a medic, but not good for a nurse or doctor.

Medical-4 is a specialist.
Medical-3 is a doctor.
Medical-2 is a nurse.
Medical-1 is basically skilled at first aid and lifeguard stuff.

That's how I think about the different degrees of skill.

 

[McPerth]

opioids such as Fentanyl can be given intramuscularly [like a blow-dart], but then the onset of effect, duration and peak dose are more variable.

I use sometimes opioids (mostly tramadol, petidine or morphine) to treat the pain of kidney stones (and some others, but that0s the most comon in my hospital), In the ER we use it intramuscular, and it takes 5-20 minutes to have effect, sometimes a little longer. Sometimes we use them subcutaneous, and it use to be little quicker to take effect.

These people are "narc'ed", but no-one with EMT, nursing or medical training would see them as "dead". If the dose is so high that the respiratory centres are depressed and the person becomes apnoeic [not breathing] thus appearing dead to the untrained [but still have a pulse]; then you only have a few minutes before brain cells start dying. Shortly after that they lose their pulse/have a cardiac arrest and are dead, needing naloxone and full resuscitation.

Years ago (sometime in the 90's) my aut told us they'd found a boy "dead" due to overdose in a bar in her street. She arrived home quite affected for it. When she told us, I (already an urse by then and having worked in ambulances, as what would be a paramedic in the US) answered "and then the ambulance came, injected him something and he fully recovered and le'f, right?". She was surprised, as this was exacly what happened.

If administered before heart stopping, naloxone is like Lazarus resurection : "raise and walk"

Medical-4 is a specialist.
Medical-3 is a doctor.
Medical-2 is a nurse.
Medical-1 is basically skilled at first aid and lifeguard stuff.

That's how I think about the different degrees of skill.

This is in CT/MT. In MgT is told Medical 2 is a doctor, and I supose medical 1 is a nurse and medical 0 either a first aid specialist (as you say) or a nursing auxiliar (not sure if you have them in US).

 

[Condottiere]

Medical/zero - Heimlich Manoeuvre

 

[McPerth]

Medical/zero - Heimlich Manoeuvre

Again, version dependent...

At CT/MT a skill at level 0 means some familiarity (so you would be right, though I'd add basic RCP, but that's argeable), but in MgT level 0 means already some experience, so I guess is more or less the equivalent to CT/MT level 1.

AFAIK TNE, T4 and T5 don't have level 0 skills...

 

[kilemall]

I use sometimes opioids (mostly tramadol, petidine or morphine) to treat the pain of kidney stones (and some others, but that0s the most comon in my hospital), In the ER we use it intramuscular, and it takes 5-20 minutes to have effect, sometimes a little longer. Sometimes we use them subcutaneous, and it use to be little quicker to take effect.



Years ago (sometime in the 90's) my aut told us they'd found a boy "dead" due to overdose in a bar in her street. She arrived home quite affected for it. When she told us, I (already an urse by then and having worked in ambulances, as what would be a paramedic in the US) answered "and then the ambulance came, injected him something and he fully recovered and le'f, right?". She was surprised, as this was exacly what happened.

If administered before heart stopping, naloxone is like Lazarus resurection : "raise and walk"



This is in CT/MT. In MgT is told Medical 2 is a doctor, and I supose medical 1 is a nurse and medical 0 either a first aid specialist (as you say) or a nursing auxiliar (not sure if you have them in US).

Yes CT doctors are Medical-3 and in addition Medical-3 and Dex 8+ is a surgeon.

I would put paramedics at Medical-2.

An obscure related skill is Xenomedical.

 

[Spinward Flow]

An obscure related skill is Xenomedical.

In CT, xenomedicine is just your regular medical skill with a -2DM applied.
So if you're Medical-3 for your own species, you're effectively Medical-1 with xenospecies (because that's how the dice work).

 

[kilemall]

In CT, xenomedicine is just your regular medical skill with a -2DM applied.
So if you're Medical-3 for your own species, you're effectively Medical-1 with xenospecies (because that's how the dice work).

Hmm, the Xenomedicine skill says a regular Medical can act with the -2 DM, but Xenomedicine is a fully listed skill with its own paragraph. It’s not listed as a skill to get in LBB1 or the explicit Doctor career in S4, so technically the only way you get it is referee fiat or using your sabbatical, but space and format wise it’s a full listing.

I suppose this would work as veterinary medicine too.

 

[Spinward Flow]

I suppose this would work as veterinary medicine too.

All you have to do is "declare a specialization" in a category of species.

Medical-3 for humaniti becomes Medical-1 for everything that's not humaniti.
Medical-3 for veterinary (species) becomes Medical-1 for humaniti/aslan/vargr/etc. etc. etc.

KISS principle still applies. No need to make things overly complicated for yourself.
Unless a Player (or a character) declares something different, their Medical skill ought to be assumed to be oriented towards their own species, but there is the OPTION to preemptively decide to specialize in a species other than your own if you want (like the aforementioned veterinary).

 

[Straybow]

That should be xenomedicine. It would be highly insulting to call med for sophants "veterinary" med.