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Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. August 20, 2024 Guest Skeptic: Dr. Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Chris completed his emergency medicine residency and EMS fellowship at UNM.
Do heroin overdose patients require observation after receiving naloxone? He is also the host of EMToxCast and gave a talk at the Association of Academic Chairs of Emergency Medicine Annual Retreat […] The post SGEM#179: Chase the Dragon and Naloxone first appeared on The Skeptics Guide to Emergency Medicine. Clinical Toxicology 2017.
Case A patient arrives via EMS from the bus station complaining of fever, vomiting, and back pain. Our experience: It was not long ago that we instructed our staff that: ‘COWS >8, give ’em 8 (mg of buprenorphine).’ Their back has worsened significantly over the past 24 hours with radiation down the left leg.
Naloxone was given for coma of unknown etiology; sodium bicarb for cardiac arrests of unknown downtime. We carried Cardizem for rapid a-fib, fentanyl for pain, intranasal naloxone, and Haldol and midazolam for violent emotionally disturbed patients. People in pulmonary edema got Lasix. Six PVCs in a minute and you got lidocaine.
Across the nation states are passing initiatives to allow EMS services to leave naloxone kits on scene with at risk patients, their family, friends or bystanders. Each kit contains two 4 mg Naloxone intranasal devices, and instruction card for use, a CPR face shield, and instructions on how to access services.
Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study. Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study. The EMS crew observes drug paraphernalia and suspect an intravenous (IV) opioid overdose.
After reviewing over 12 million EMS incidents that took place in 2023 , the 2024 ESO EMS Index highlights two critical areas that demand attention: Early CPR and Opioid Use Disorder (OUD). Bystander CPR has been shown to double survival rates compared to cases where no CPR is performed prior to EMS arrival. Want to learn more?
In this episode Dr. Kathryn Dong, Dr. Michelle Klaiman and Dr. Aaron Orkin discuss the latest in naloxone in opioid overdose cardiac arrest and altered LOA, a 5-step approach to ED opioid withdrawal management and how we can improve mortality and morbidity in patients with opioid use disorder in the era of the opioid epidemic.
The post EM Quick Hits 8 Lemierre’s Syndrome, Clonidine Toxicity, Routine Coag Panel, Anticoagulation Reversal, Mechanical CPR appeared first on Emergency Medicine Cases.
This study investigated whether it is feasible to initiate buprenorphine/naloxone in the form of “take home” packages containing low-dose and standard-dose inductions. REBEL Cast Ep117: Low-Dose vs Standard-Dose Take Home Buprenorphine From the ED Click here for Direct Download of the Podcast Paper: Moe et. PMID 33392580.
Melody Glenn ( @MGlennEM ) Dr. Jeremy Cushman ( @hws96 ) about their manuscripts Refusals After Prehospital Administration of Naloxone during the COVID-19 Pandemic and Degree of Bystander-Patient Relationship and Prehospital Care for Opioid Overdose EMS Chain of Survival while discussing the idea of utilizing a Chain of Survival for patients suffering (..)
mg of Naloxone X 2, and now the ETCO2 drops to 45, the SAT soon comes up to 99 and the patient opens her eyes and lifts her head, surprised to find herself surrounded by EMS and Fire. EMS in Connecticut is required by regulation to call the Poison Control Center to report all suspected opioid overdoses they respond to.
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 (..)
EMS has a pivotal role in helping to combat these deaths, both but providing resuscitation with naloxone, but also in helping steer those resuscitated patients toward treatment and harm reduction resources. While the decline is good news, the number of people in our state (1217) succumbing to opioid deaths is still achingly high.
Paramedics and EMTs can rescue patients with naloxone, but are we the right avenue to start people toward recovery? The State of New Jersey, in the throes of an enormous opioid epidemic, has unveiled allowing their Mobile Intensive Care Units (Paramedics) to administer buprenorphine as a part of an optional formulary. What does this mean?
DISCLAIMER : I’m not doing this episode to discredit those in law enforcement, the fire service, EMS, or any other first responders. 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. We just clean it up.
Here are some of the highlights: EMRs and EMTs may administer Naloxone IM in a dose of 0.4 Paramedics may administer buprenorphine to patient in precipitated withdrawal following naloxone resuscitation provided the patient meets required criteria and agrees to hospital transport.* mg via syringe.* micrograms/kg/min. .*
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. Andrew Herring EMS Public Health Initiative (..)
In EMS many times when we meet persons with opioid use disorder (the correct language to describe what we used to call junkies — a stigmatized term that originated with “junk men” people who went through garbage –the connotation indicating human trash), we find them at rock bottom. Good job,” I say to the young EMT.
Patients with opiate overdose get naloxone. Wilson MP, Chen N, Vilke GM, Castillo EM, MacDonald KS, Minassian A. 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.
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. Sundd P, Gladwin MT, Novelli EM. C or 100.4 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02
ACMT & AACT Joint Position Statement on Nalmefene Should Not Replace Naloxone as the Primary Opioid Antidote at This Time. Fact: Newer synthetic fentanyls do not require more doses of naloxone than traditional to reverse an overdose. Naloxone Dosing After Opioid Overdose in the Era of Illicitly Manufactured Fentanyl.
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. Upon arrival, his vitals were as follows: heart rate of 132 bpm, respiratory rate of 27, blood pressure of 134/75 mm Hg, and a SpO 2 of 100 percent.
An EM Residents Guide to Basic Airway Management Authors: Justin Rice, MD Sagar Desai, MD Eunice Monge, MD William Chiang, MD Preface: Airway management is one of the most critical skills in emergency medicine, yet it can be one of the most challenging to master. naloxone), the person is likely to get intubated.
Still, just based on public statements, it seemed the alternative was likely to be closer to send them all up the river, put ‘em behind bars and throw away the keys than the more moderate drug policy we have seen under Biden/Harris. Make naloxone available at little or no cost to the public. Well, the people have spoken.
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