ACEP Now

JULY 7, 2023

CASE A 30-year-old woman presents to the emergency department with left arm pain from a chronic wound. While naloxone can treat fentanyl overdose, overdose symptoms may persist when xylazine is involved. Opioid overdoses involving xylazine in emergency department patients: a multicenter study. Alexander RS, et al.

Overdose 98

Overdose ALS Naloxone Emergency Department 98

ACEP Now

OCTOBER 15, 2023

1 The emergency department remains an important frontier for work in judicious prescribing, but opiate analgesia remains a valuable tool for the initial treatment of a variety of presentations. 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

Bupe Allergy Buprenorphine induction has been the mainstay of emergency department treatment of opioid use disorder for more than a decade [11, 12]. The biggest change has been the gradual replacement of diacetylmorphine (heroin) by fentanyl and other synthetic opioids.

E-9-1-1 161

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

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.

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

The pain worsened today, prompting him to come to the emergency department for evaluation. Necrotizing fasciitis Case Question: Will naloxone reverse a xylazine overdose? The patient reported a wound to his left leg that had become larger over the past 5 months. BMP : Na 126; K+ 5.9; up from 0.69) ESR : >100 CRP : 15.94

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. It is illegal in six states and not regulated in 33 states. The pathophysiology of withdrawal from kratom use is not well studied.

NARCAN 89

NARCAN Naloxone Overdose Mental Health Services 89

Peter Canning

DECEMBER 6, 2024

There has been much speculation and the answer probably doesnt lie with one factor but with many, including increased availability of naloxone, the efforts of harm reduction workers, the end of the COVID isolation, the trend away from injecting to snorting or smoking, a less toxic drug supply, and expanded treatment.

Overdose 52

Overdose Naloxone Emergency Department OR 52

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