The Skeptics' Guide to EM

AUGUST 27, 2022

Date: August 23rd, 2022 Reference: Schoenfeld et al. Date: August 23rd, 2022 Reference: Schoenfeld et al. He is successfully resuscitated using naloxone and is stable after an observation period. Reference: Schoenfeld et al. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM.

Emergency Department 100

Emergency Department Naloxone Overdose ED 100

ACEP Now

JULY 7, 2023

While naloxone can treat fentanyl overdose, overdose symptoms may persist when xylazine is involved. References Friedman J, et al. Alexander RS, et al. Love JS, et al. Reyes JC, et al. Ruiz-Colón K, et al. Capraro AJ, et al. Rodríguez N, et al. Malayala SV, et al. 2022;233:109380.

Overdose 98

Overdose ALS Naloxone Emergency Department 98

ACEP Now

DECEMBER 10, 2023

Though paramedics administered naloxone, he remained somnolent. You ultimately begin a slow naloxone infusion and admit him to the medical ICU. You question yourself for ordering IV potassium and starting a naloxone infusion, knowing you are causing discomfort for the patient who has known significant cancer-related pain.

Naloxone 52

Naloxone Life Support Paramedic ALS 52

ACEP Now

OCTOBER 15, 2023

After enrollment, patients were randomized either to a modified-release oxycodone-naloxone combination opiate, starting with an initial dose containing 5 mg of oxycodone, or placebo. The addition of naloxone to the tablets may also provide a confounder in terms of the analgesia provided. Jones CMP, Day RO, Koes BW, et al.

Emergency Department 52

Emergency Department Naloxone ALS OR 52

ACEP Now

JULY 7, 2023

Patients with opiate overdose get naloxone. References American College of Emergency Physicians Clinical Policies Subcommittee on the Adult Psychiatric P, Nazarian DJ, Broder JS, et al. Currier GW, Chou JC, Feifel D, et al. Zaman H, Sampson SJ, Beck AL, et al. Patients with sepsis get antibiotics. Ann Emerg Med.

Emergency Department 52

Emergency Department ED Naloxone ALS 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

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. PEARL #3: The pathophysiologic mechanism for producing amphetamine-induced acute MI is unclear ( Bazmi et al — SQUMJ 17(10); e31-37, 2017 — and — Sinha et al — Case Rep Cardiol, 2016 ).

Coronary 52

Coronary ACS Naloxone Plasma 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. Alkindi S, Al-Busaidi I, Al-Salami B, Raniga S, Pathare A, Ballas SK. C or 100.4 mg/kg, max 0.4

E-9-1-1 97

E-9-1-1 ICU ACS EMS 97

EMDocs

JANUARY 22, 2025

In the field, he was given 4 mg intranasal (IN) naloxone and rescue breaths via bag valve mask. He is administered 2mg intravenous (IV) naloxone and shortly after develops precipitated withdrawal with altered mental status, diaphoresis, vomiting, and diarrhea. When should a naloxone infusion be considered?

Naloxone 96

Naloxone E-9-1-1 Overdose NARCAN 96

ALiEM

JANUARY 6, 2025

Necrotizing fasciitis Case Question: Will naloxone reverse a xylazine overdose? References Papudesi, Bhavani Nagendra, et al. Laboratory Data CBC : Hgb 2.74 (compared to baseline of 9.0); WBC count 17.39 BMP : Na 126; K+ 5.9; up from 0.69) ESR : >100 CRP : 15.94 However, fentanyl is the most common drug combined with xylazine.

NARCAN 141

NARCAN Overdose Naloxone Emergency Department 141

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. Gummin DD, Mowry JB, Beuhler MC, et al. Todd DA, Kellogg JJ, Wallace ED, et al. Obeng S, Kamble SH, Reeves ME, et al. 2022;23(1):4-9.

NARCAN 89

NARCAN Naloxone Overdose Mental Health Services 89

Don't Forget the Bubbles

JULY 5, 2023

Naloxone (opioid antidote) should be available in ED in case of severe respiratory depression. Macharia AW et al. Sinkin JC, Wood BC, Sauerhammer TM, et al. Ware et al. In addition to opiates, continue to offer paracetamol and NSAIDS (unless contraindicated). Monitor vital signs for respiratory depression. 2014; 349–356.

E-9-1-1 126

E-9-1-1 ACS OR ICU 126

Core EM

JANUARY 16, 2025

naloxone), the person is likely to get intubated. et al (2022). Bacon ER,et al Tips and Troubleshooting for Use of the GlideScope Video Laryngoscope for Emergency Endotracheal Intubation. Bacon ER,et al Tips and Troubleshooting for Use of the GlideScope Video Laryngoscope for Emergency Endotracheal Intubation. 2003): 4-9.

E-9-1-1 130

E-9-1-1 EMS ALS OR 130