ALiEM

NOVEMBER 29, 2023

Recently, xylazine has gained attention in the media with increasing reports of xylazine-related overdose deaths in patients. When combined with illicit opioids such as heroin and fentanyl, xylazine may increase the risk of fatal overdose given the augmented sedation and respiratory depression effects [2]. Published 2021 Sep 17.

Naloxone 169

Naloxone Overdose Epinephrine ALS 169

Peter Canning

OCTOBER 1, 2024

Is the decline in drug overdose deaths more related to the increased availability of naloxone, improved treatment for people who use drugs, or changes in the street drug supply, which while still quite toxic may be less so due to adulteration with other chemicals? A recent article in NPR, The pipeline of deadly fentanyl into the U.S.

Overdose 52

Overdose Naloxone OR 52

Peter Canning

MAY 22, 2024

Drug overdose deaths are down 3.1% 107,543 people died of drug overdoses in 2023 down from 111,029 in 2022. Here in Connecticut, drug overdose deaths have been decreasing for the last two years (down 14% in 2023 from the 2021 high). Ten years ago when I responded to an overdose, I was the only one carrying naloxone.

Overdose 52

Overdose Naloxone First Responder OR 52

REBEL EM

SEPTEMBER 27, 2023

Mohan 2021 ) Recall that the subsequently alkalemia will shift potassium intracellular. Value of the QRS duration versus the serum drug level in predicting seizures and ventricular arrhythmias after an acute overdose of tricyclic antidepressants. A Case of Massive Diphenhydramine and Naproxen Overdose. 2021 Sep;61(3):259-264.

E-9-1-1 100

E-9-1-1 Overdose EMS 100

Peter Canning

MARCH 5, 2024

Connecticut opioid-related deaths declined for the second year in a row, down 14% from their 2021 high of 1431 opioid deaths, according to the latest statistics from the Connecticut Office of the Medical Examiner (OCME). Opioid deaths represented 92% of all overdose deaths in Connecticut.

Overdose 52

Overdose Naloxone EMS OR 52

Pediatric EM Morsels

JUNE 16, 2023

Sometimes this can be used to our advantage, like when we need to give subcutaneous fluids to a dehydrated patient without an IV, or when we need to give SQ medications for things like Sulfonylurea overdose , Hereditary Angioedema , or DVTs. 2021) Morel-Lavallee lesion , Orthobullets. PMID: 30190632; PMCID: PMC6126206. Arch Gen Med.

Overdose 154

Overdose OR Critical Care ALS 154

ACEP Now

JULY 7, 2023

Xylazine is a veterinary sedative that has been increasingly implicated in overdose deaths throughout the United States. Since 2020 to 2021, the Drug Enforcement Administration has reported a sharp rise in xylazine use across the U.S., percent of all overdose deaths in 2020. 4-6 Skin necrosis due to patient using xylazine.

Overdose 98

Overdose ALS Naloxone Emergency Department 98

REBEL EM

JUNE 5, 2023

Background Information: Opioid overdose deaths have been increasing in the past twenty years. The national number of overdose deaths from any opioid has increased 62.5% In addition, buprenorphine has a lower risk of death from overdose when compared to methadone (2). Characteristics: Mean age 35.5 Homeless: 32.6%

Naloxone 88

Naloxone ED Overdose Emergency Department 88

EMDocs

AUGUST 3, 2023

Massive acetaminophen overdose: effect of hemodialysis on acetaminophen and acetylcysteine kinetics. A multicenter comparison of the safety of oral versus intravenous acetylcysteine for treatment of acetaminophen overdose [published correction appears in Clin Toxicol (Phila). Adverse reactions to acetylcysteine and effects of overdose.

Overdose 98

Overdose E-9-1-1 OR ED 98

FOAMfrat

JUNE 3, 2024

Right as you’re making your bunk you get dispatched for a reported overdose with police enroute, no further information. We go into it with preconceptions of what to expect: “It’s a simple heroin overdose, we’ll wake them up and they’ll refuse, then we’ll go back to bed”. 2021 Dec;5(12):e660. References: Castiglione, M.

Overdose 98

Overdose Ambulance First Responder ALS 98

EMDocs

JANUARY 17, 2024

What are the treatment options for a benzonatate overdose? 7) Overdose literature review timeline: In 1986, the first two benzonatate fatalities were reported in the literature: a choking infant and an intentional overdose in a teenager. (8) There is no specific toxidrome or antidote for a benzonatate overdose.

E-9-1-1 86

E-9-1-1 Overdose Emergency Medical Services Life Support 86

Clinical Correlations

APRIL 2, 2024

Jackson Peer Reviewed During the COVID-19 pandemic, opioid overdose deaths increased from 50,000 in 2019 to 80,000 in 2021, largely driven by synthetic opioids such as fentanyl.1 By Sarah M. 1 Despite the escalating use of synthetic.

Overdose 52

Overdose 52

Peter Canning

SEPTEMBER 19, 2024

overdose deaths plummet, saving thousands of lives, blared the headline from NPR yesterday. Here in Connecticut, we witnessed a decline beginning in November 2021. Ten years ago when I responded to an overdose, I was the only one carrying naloxone. We know what works! Let’s double our efforts!

Naloxone 52

Naloxone Overdose First Responder OR 52

EMDocs

FEBRUARY 15, 2024

7,10 Contraindications include asthma, chronic obstructive pulmonary disease (COPD), genitourinary or gastrointestinal obstruction, or if there is suspected or confirmed tricyclic antidepressant (TCA) overdose. 2021 Aug;59(8):698-704. Physostigmine does not reverse seizures or dysrhythmias. 9 Physostigmine dosing: 0.5-2

E-9-1-1 110

E-9-1-1 Overdose ED OR 110

EMDocs

JANUARY 16, 2024

In our case, the patient had accidentally overdosed on drugs prior to being found. European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Accidental Hypothermia: 2021 Update. 17 It is crucial to figure out why the patient is hypothermic and reverse the underlying cause if possible. N Engl J Med.

Defibrillator 107

Defibrillator CPR Epinephrine Life Support 107

NAEMSP

APRIL 19, 2023

Calcium is also frequently used in the treatment of hyperkalemia, calcium channel blocker overdose, hypermagnesemia, and hypocalcemia and may be more likely to be used when one of these diagnoses is the suspected cause of cardiac arrest. 2021), and AHA guidelines also maintain this use (Panchal, et al., References: 1. Ramazan, K.,

E-9-1-1 52

E-9-1-1 Advanced Life Support Overdose CPR 52

EMDocs

JUNE 2, 2023

doi: 10.1136/bmjopen-2021-059876. mg/kg/dose (PO/IM/IV) Midazolam – 0.25-0.5 mg/kg/dose PO; 0.2-0.3 mg/kg IN; 0.1-0.15 Qualitative study of patient experiences and care observations during agitation events in the emergency department: implications for systems-based practice. 2022 May 11;12(5):e059876. PMID: 35545394; PMCID: PMC9096567.

Emergency Department 89

Emergency Department Emergency Medical Services Overdose ED 89

Handtevy

AUGUST 15, 2022

Sodium bicarbonate is indicated for select patients including preexisting metabolic acidosis, hyperkalemia, or tricyclic antidepressant overdose. Children ≤ 18 years old and ≥ 37 weeks post conceptual age who received chest compressions from October 2016 to March 2021. 1.34; p = 0.621).

CPR 52

CPR ICU Overdose Critical Care 52

Dr. Smith's ECG Blog

JULY 21, 2024

These are also the most commonly reported findings in toxic overdoses with ventricular arrhythmias being reported as the leading cause of death. The decision was made to try Quinidine ( as this case was felt to represent conditions consistent with Quinidine-responsive PMVT ). Numbers given are based mostly on case reposts.

Defibrillator 131

Defibrillator Coronary ALS STEMI 131

AAEM RSA

MARCH 4, 2021

Image credit: Pexels Author: Jennifer Gemmill, MD FAAEM Originally published: Common Sense January/February 2021 I am a terrible patient. I frantically resuscitated a man with hypotension and bradycardia for multiple hours with no effect, only to discover later that he had intentionally overdosed on his blood pressure meds.

Overdose 52

Overdose OR ED EMS 52

Dr. Smith's ECG Blog

MAY 5, 2023

Krantz et al authored a State-of-the-Art Review on Cardiovascular Complications of Opioid Use ( JACC 77(2):205-223, 2021 ) — in which mechanisms from Opioid Overdose that detail arrhythmia production ( up to cardiac arrest ) are elucidated — thereby providing an explanation for the unusual arrhythmias in today's case.

E-9-1-1 52

E-9-1-1 NARCAN Naloxone Overdose 52

Pediatric EM Morsels

SEPTEMBER 1, 2023

Sex 1/3 US high schoolers are having sex [ Youth Risk Behavior Survey 2021 ] Adolescents with higher levels of risky sexual behavior are more likely to report the ED as their usual source of care. In a teen who presents with vomiting and abdominal pain, is this “just” viral gastroenteritis, or could this be a Tylenol overdose ?

ED 164

ED Emergency Department Overdose ALS 164

EMDocs

DECEMBER 16, 2023

Temps greater than 41.5C per minute) 1,4 Body bag may be utilized if no immersion tank available 3 Evaporative cooling (DT 0.1C C., & Mathai, D. Predictors of multi-organ dysfunction in heatstroke. Emergency medicine journal : EMJ , 22 (3), 185–187. link] Jang, S. H., & Seo, Y. Medicine , 100 (13), e24053. Autonomic Dysfunction.

EMS 92

EMS Heatstroke Emergency Department First Aid 92

Peter Canning

MARCH 12, 2025

Fatal Overdoses continue to show a decline both nationally (27.5% from our rolling 12-month high of November 2021), according to just released data from the CDC which reflects their data through the end of October 2024. from the June 2023 rolling 12-month high) and here in Connecticut (32.7% Those are no insignificant numbers.

Overdose 59

Overdose Naloxone OR 59

Peter Canning

DECEMBER 7, 2024

Connecticut reached its 12-month rolling fatal overdose peak in November 2021. As of June 2024, overdoses are down 24.2%. This data comes from the CDC Vital Statistics web page that tracks overdoses in all 50 states and the District of Columbia. I compiled the list by reviwing each state’s charts. Stay tuned.

Overdose 52

Overdose OR 52

Peter Canning

NOVEMBER 13, 2024

The latest CDC data released today show US overdose deaths are down 16.74% from the rolling 12-month high of 111,802 in August of 2023 to June 2024 count of 93,087(the latest provisional data available). We will win this war. Harm reduction workers in Hartford Connecticut, making Naloxone kits.

Overdose 59

Overdose Naloxone 59

Peter Canning

DECEMBER 11, 2024

Fatal Overdoses continue to plummet nationwide. The latest CDC 12-month rolling fatal overdose averages through July 20024 are out today and they show the fatal overdoses in the USA are down 19.4% Here in Connecticut, fatal overdoses are down 26.8% from our November 2021 high.

Overdose 52

Overdose 52

ALiEM

JANUARY 6, 2025

A 32 year-old male with PMH significant for opioid use disorder, a prior admission in 2021 for left-sided empyema s/p thoracotomy and decortication, gas bacteremia, and tricuspid endocarditis presented for a left leg wound. Necrotizing fasciitis Case Question: Will naloxone reverse a xylazine overdose?

NARCAN 141

NARCAN Overdose Naloxone Emergency Department 141

EMDocs

JANUARY 22, 2025

Background: Fentanyl has contributed to a significant increase in drug overdose deaths in recent years. A prospective study of 453 patients who were admitted after receiving naloxone reported life-threatening complications in over 1% of heroin-overdosed patients. Clinical Pearls: Naloxone is lifesaving in opioid overdoses.

Naloxone 94

Naloxone E-9-1-1 Overdose NARCAN 94

Peter Canning

DECEMBER 6, 2024

Why are overdoses fatalities dropping? Today, I want to examine one possible factor — the increasing presence of xylazine in the drug supply, which I have written about before Xylazine Hysteria Xylazine Decreases Overdose Deaths? All have seen declining fatal overdose rates. Overdose deaths are down significantly.

Overdose 52

Overdose Naloxone Emergency Department OR 52

Peter Canning

MARCH 2, 2025

A report, Detection of Illegally Manufactured Fentanyls and Carfentanil in Drug Overdose Deaths United States, 20212024 , published on December 5, 2024 in the CDCs Morbidity and Mortality Weekly Report (MMWR) warns of increasing drugs deaths caused by carfentanil. Potency must be considered in relation to volume.

Overdose 59

Overdose Naloxone OR 59

Peter Canning

JANUARY 15, 2025

The latest CDC provisional 12-month rolling numbers (through August 2024) are out for fatal overdoses and the news continues to be promising. The US reported overdose fatal numbers are down 23.2 % from the August 2023 high. * In Connecticut reported overdoses are down 29.9% Impressive. They also list predicted numbers.

Naloxone 52

Naloxone Overdose NARCAN OR 52

Peter Canning

FEBRUARY 13, 2025

In an article by New England Public Media, Health experts alarmed at new overdose drug marketed to WMass police departments , a police chief in Dalton Mass stunningly poo-poos the experts warnings about the drug, actually saying, The DPH and these people, they’re not in the field, she said. They felt faint, some even passed out.

Naloxone 64

Naloxone Overdose Emergency Medical Services EMS 64

AAEM RSA

APRIL 18, 2021

Sobrio, MD Originally published: Common Sense March/April 2021 Flashback to 2019. In 2018, drug overdose deaths dropped for the first time in 20 years. It is not surprising that tragedies such as overdoses, and suicides are up. Image credit: Pexels Author: Shane A. Hong Kong protests were raging on, the U.S.

Overdose 52

Overdose Naloxone OR 52