ALiEM

OCTOBER 30, 2024

Alternatively, one can cut the 2 mg Suboxone (buprenorphine + naloxone combination) strips into 4 pieces after waiting for a longer washout period (72-96 hours of abstinence from non-medical opioids) before starting the induction. DOI: Papudesi BN, Malayala SV, Regina AC. Or one can start methadone induction. 2023 Aug 1;89(2):231.

E-9-1-1 161

E-9-1-1 Naloxone Emergency Department ALS 161

Dr. Smith's ECG Blog

JULY 27, 2023

This 29 year old African American patient was found down, unconscious, not breathing and was given 2 mg of intranasal naloxone by a bystander. I did not think it was due to ACS, but we ordered an ED ECG immediately: What do you think? He then received bag-valve-mask ventilations for several minutes until he became responsive.

Coronary 52

Coronary ACS Naloxone Plasma 52

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

He awoke with naloxone. The 50-something patient with history of coronary stenting and slightly reduced LV ejection fraction. He had been smoking an opiate and suddenly collapsed. He was ventilated with BVM on arrival. This EKG was recorded as part of a standing order for critical care. He denied any CP or SOB.

Overdose 52

Overdose OR Coronary ACS 52

EMDocs

JUNE 27, 2024

mg q20-30 min per dose) PRN naloxone in case of respiratory depression Some patients have SCD crises pain plan for reference Antimicrobials 11 Ceftriaxone + azithromycin if penicillin allergy for both children and adults. Chinawa JM, Ubesie AC, Chukwu BF, Ikefuna AN, Emodi IJ. C or 100.4 mg/kg, max 0.4 C or 100.4 mg/kg, max 0.4

E-9-1-1 97

E-9-1-1 ICU ACS EMS 97

Don't Forget the Bubbles

JULY 5, 2023

Opioids do not cause ACS but they can exacerbate hypoxia in patients with ACS. Naloxone (opioid antidote) should be available in ED in case of severe respiratory depression. The treatment for ACS is mainly supportive: Oxygen : supplemental oxygen should be given only when the patient is hypoxic (saturation of oxygen < 94%).

E-9-1-1 126

E-9-1-1 ACS OR ICU 126

ACEP Now

FEBRUARY 11, 2025

A 33-year-old male with a history of drug use presented to the emergency department (ED) for extreme agitation after receiving two doses of 2 mg naloxone by EMS for respiratory depression. Kruegel AC, Gassaway MM, Kapoor A, et al. Gold MS, Pottash AC. That is, they experienced nausea, vomiting, chills, myalgias, and diarrhea.

NARCAN 89

NARCAN Naloxone Overdose Mental Health Services 89