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. percent of all overdose deaths in 2020.

Overdose 98

Overdose ALS Naloxone Emergency Department 98

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.

Emergency Department 52

Emergency Department Naloxone ALS OR 52

ALiEM

OCTOBER 30, 2024

The biggest change has been the gradual replacement of diacetylmorphine (heroin) by fentanyl and other synthetic opioids. Along the same time, a veterinary sedative, xylazine , became popular in Puerto Rico in individuals who used injection drugs [3]. We treat with wound care and reserve surgical management only for limbs that are no longer viable.

E-9-1-1 161

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

ACEP Now

JULY 7, 2023

Patients with opiate overdose get naloxone. This month, we are discussing the medical management of patients with mild to moderate agitation. Emergency departments (EDs) focus on rapid initiation of medical treatment. Patients with sepsis get antibiotics. Patients in DKA get insulin.

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

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

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. Left lower lung field end demonstrates expiratory wheezing on auscultation. Other lung fields unremarkable. C or 100.4

E-9-1-1 95

E-9-1-1 ICU ACS EMS 95

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 93

Naloxone E-9-1-1 Overdose NARCAN 93

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

Don't Forget the Bubbles

JULY 5, 2023

This process of sickling and unsickling goes on and off until the erythrocyte membrane is no longer flexible. Irreversible sickle cells undergo either intravascular haemolysis or extravascular removal by the reticulo-endothelial system resulting in anaemia and splenic sequestration. Blood culture is pending. How would you evaluate this child’s pain?

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. 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

Core EM

JANUARY 16, 2025

Success at intubation likely takes more time and practice than other procedures, as shown in recent research on ED residents and their success rate at intubating, measured as a function of their total number of intubations (See Figure 1). Practice may not achieve perfection, but it will make you better. fiber optic through the nose).

EMS 130

EMS E-9-1-1 ALS OR 130