The Skeptics' Guide to EM

AUGUST 27, 2022

Just give them a choice”: Patients’ perspectives regarding starting medications for opioid use disorder in the ED. Just give them a choice”: Patients’ perspectives regarding starting medications for opioid use disorder in the ED. Case: A 24-year-old male presents to the emergency department (ED) after a fentanyl overdose.

Emergency Department 100

Emergency Department Naloxone Overdose ED 100

EMDocs

NOVEMBER 6, 2023

This post will focus on the key parts of the guideline that affect ED evaluation and management. Naloxone administration may reverse respiratory arrest, preventing progression to cardiac arrest. Editorial Comment: Naloxone first, flumazenil only for pure benzo’s (e.g., Top 10 Take Home Pearls 1. COR No Benefit, LOE C-EO.

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Naloxone OR BLS Overdose 115

Emergency Medicine Cases

OCTOBER 9, 2018

In anticipation of EM Cases Episode 116 on Opioid Misuse, Overdose and Withdrawal, Dr. Michelle Klaiman, Addictions and Emergency Medicine specialist, tells her Best Case Ever exemplifying how we can positively impact the lives of ED patients for years to come - even when they present with simple, run-of-the-mill diagnoses - by thinking outside the (..)

Overdose 130

Overdose ED EMS Naloxone 130

ACEP Now

DECEMBER 10, 2023

A middle-aged male with squamous cell carcinoma and extensive metastases is brought to the emergency department (ED) after being found unresponsive following a believed suicide attempt (SA) by methadone ingestion. Though paramedics administered naloxone, he remained somnolent. You order IV potassium and magnesium. Canada, SCC 5.

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Naloxone Life Support Paramedic ALS 52

EMergucate

JULY 2, 2018

50 year old male presents to ED after a heroin OD. The patient had CPR on scene and responded to … Continue reading →

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CPR ED Naloxone 100

EM Basic

MARCH 13, 2019

Nothing happens, no one dies and no one needs naloxone. He felt tired and then a few minutes later loaded himself up with naltrexone which is a long acting version of naloxone. Nope- nothing changed- no hazmat suits, we didn’t carry naloxone to protect ourselves, nothing like that. We just clean it up. Period, end of story.

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Naloxone Overdose First Responder NARCAN 52

ACEP Now

AUGUST 29, 2023

Visit acep.org/equal-opioids-webinars to view these videos on demand: Equity in ED Care for Opioid Use Disorder presented by Dr. Elizabeth Samuels and Dr. Utsha Khatri The Naloxone Project presented by Dr. Don Stader Starting Buprenorphine in the Emergency Department to Help People Using Fentanyl presented by Dr.

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E-9-1-1 Naloxone Emergency Department EMS 52

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. Patients with opiate overdose get naloxone. Future articles will highlight solutions and success stories. Patients in DKA get insulin.

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Emergency Department ED Naloxone ALS 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. On arrival to the ED, the patient was diaphoretic, tachycardic. I did not think it was due to ACS, but we ordered an ED ECG immediately: What do you think? and had dilated pupils.

Coronary 52

Coronary ACS Naloxone Plasma 52

CanadiEM

JANUARY 23, 2024

Ken’ is a 47-year-old unhoused man presenting to the Emergency Department (ED) with severe opioid withdrawal symptoms. Editor’s Note: This is part 2 of a 2-part series on homelessness. Check out Part I about the Ottawa Inner City Health Initiative.

Emergency Department 52

Emergency Department ED Naloxone 52

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

He awoke with naloxone. After discussing all of the above with ED staff, we have made a decision to get stat echocardiogram and assess overall LV function and wall motion abnormalities and defer cath lab activation at the time." The 50-something patient with history of coronary stenting and slightly reduced LV ejection fraction.

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Overdose OR Coronary ACS 52

EMDocs

JUNE 27, 2024

An 8-year old male with a history of sickle cell anemia presents to the ED for evaluation of fever for 2 days and “feeling like I can’t get a full breath”. 768: Epidemiology of Hospital Based ED Visits due to Sickle Cell Crisis and Acute Chest Syndrome in Kids. C or 100.4 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02

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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. In the ED, he develops recurrent respiratory depression and hypoxia to 80%. He is administered 2mg intravenous (IV) naloxone and shortly after develops precipitated withdrawal with altered mental status, diaphoresis, vomiting, and diarrhea.

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Naloxone E-9-1-1 Overdose NARCAN 96

Don't Forget the Bubbles

JULY 5, 2023

Haematology specialist clinics are key to manage the chronic side of the disease, while ED doctors should be able to act rapidly on the common acute emergencies. with thanks A 15-month-old Kenyan boy presents to ED with right hand swelling. A 10-year-old boy with known SCA presents to ED due to severe pain in the legs.

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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. If available, an in-house ED pharmacist is an incredible resource for guidance when there are questions regarding pharmacologic management.

NARCAN 89

NARCAN Naloxone Overdose Mental Health Services 89

Core EM

JANUARY 16, 2025

While this guide isnt exhaustive, its designed by residents, for residents, to provide practical tips and foundational knowledge thats crucial in the fast-paced, high-stakes environment of the ED. Introduction Airway management is a critical ED skill to master. So the actual benefit for most ED patients is unclear.

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E-9-1-1 EMS ALS OR 130