Emergency Medicine Cases

OCTOBER 23, 2018

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.

Overdose 130

Overdose Emergency Management Emergency Manager Naloxone 130

ESO

DECEMBER 18, 2024

The 2024 ESO EMS Index reveals that 82% of patients with suspected opioid overdoses received naloxone, a medication that can reverse opioid effects. A pproximately 65% of these p atients were male , with 63% documented as White non-Hispanic followed by 24% as Black or African American and non-Hispanic. So, w hat can your agency do?

CPR 52

CPR Naloxone Overdose Defibrillator 52

EMDocs

NOVEMBER 6, 2023

Naloxone administration may reverse respiratory arrest, preventing progression to cardiac arrest. Editorial Comment: Naloxone first, flumazenil only for pure benzo’s (e.g., Give naloxone for suspected opioid overdose and respiratory compromise/arrest. COR No Benefit, LOE C-EO. COR Harm, LOE B-R. if used for sedation).

Naloxone 116

Naloxone OR Overdose BLS 116

EMergucate

JUNE 27, 2012

Naloxone Epinephrine Atropine Lignocaine yes you can !

Naloxone 100

Naloxone Epinephrine 100

EM Literature of Note

AUGUST 18, 2023

Modified-release oxycodone-naloxone was the opiate of choice in this Australian trial. The naloxone itself does not exert much influence on the analgesic effect, but the preparation itself differs from preparation used commonly in the emergency department.

Naloxone 86

Naloxone Emergency Department OR 86

Peter Canning

JANUARY 27, 2024

In the case of naloxone, unlike say milk, the product doesn’t spoil and it retains its potency for many years. Yes, naloxone works for years after its expiration date. One study showed naloxone stayed viable even after thirty years of storage in a less than ideal setting.

NARCAN 59

NARCAN Naloxone Overdose OR 59

Peter Canning

DECEMBER 6, 2023

I take the naloxone out of my med kit, draw up a small amount in a syringe and slowly push it through the IV. We had to give you naloxone. We gave him a little naloxone and he came around. You should have naloxone in your house. I tell her how to recognize an overdose and where to get naloxone and how to use it.

Naloxone 52

Naloxone Overdose NARCAN 52

Critical Care Scenarios

OCTOBER 11, 2023

Extremity neuro changes should prompt driving the MAP >90, naloxone, and IV steroids. . * Open repair of type B dissection has become vanishingly rare due to high morbidity and rare indication. Stenting of the aorta creates risk for spinal cord ischemia, so keep BP higher.

Naloxone 100

Naloxone Coronary OR 100

Prehospital Emergency Care Podcast

MAY 21, 2021

Jeremiah Escajeda have a conversation with Dr. Molly McCann Dr. 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 (..)

Naloxone 52

Naloxone Overdose EMS 52

Prehospital Emergency Care Podcast

JULY 28, 2022

As always THANK YOU for listening. Hawnwan Philip Moy MD ( @pecpodcast) Scott Goldberg MD, MPH ( @EMS_Boston ) Jeremiah Escajeda MD, MPH ( @jerescajeda ) Joelle Donofrio-Odmann DO ( @PEMems) Maia Dorsett MD PhD ( @maiadorsett ) Lekshmi Kumar MD, MPH ( @gradyMED1 )

Naloxone 52

Naloxone Overdose EMS 52

FOAMfrat

AUGUST 1, 2023

In this book, we're coving: Oxygen Albuterol and Atrovent Epinephrine Aspirin Nitroglycerin Naloxone Oral Glucose Gel and Glucagon + Flashcards in the back! We've also included medication profiles, tips and tricks from experienced providers, and flashcards for each medication to help you hone your med knowledge base!

EMT 52

EMT EMT Naloxone Epinephrine 52

The Overrun Podcast

JULY 3, 2019

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?

Mobile Intensive Care Unit 52

Mobile Intensive Care Unit Paramedic Naloxone EMT 52

Peter Canning

JANUARY 14, 2024

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.

CPR 52

CPR Naloxone EMT EMT 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.

Emergency Department 52

Emergency Department Naloxone ALS OR 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. Andrew Herring EMS Public Health Initiative (..)

E-9-1-1 52

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

Dr. Smith's ECG Blog

MAY 5, 2023

The "good" news — Treatment with naloxone will probably resolve the bradycardia. Figure-4: Review of the 2 long lead rhythm strips from today's case.

E-9-1-1 52

E-9-1-1 NARCAN Naloxone Overdose 52

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

Emergency Medicine Cases

SEPTEMBER 10, 2019

Anand Swaminathan on Lemierre's syndrome, Emily Austin on clonidine toxicity, Brit Long on myths of routine coagulation panel testing, Hans Rosenberg and Michael Ho on reversal of anticoagulation, Sheldon Cheskes on mechanical CPR.

CPR 130

CPR EMS Naloxone 130

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 ALS Naloxone 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. He then received bag-valve-mask ventilations for several minutes until he became responsive. He had a prehospital ECG that was worrisome to the medics, so they called me to see him at the door.

Coronary 52

Coronary ACS Naloxone Plasma 52

The Skeptics' Guide to EM

MAY 21, 2017

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.

Naloxone 130

Naloxone Overdose First Responder BLS 130

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 →

CPR 100

CPR ED Naloxone 100

EMergucate

JULY 4, 2018

50 year old male presents post heroin OD VBG Respiratory acidosis – pH 7.17 pCO2 84mmHg Compensation – Expected HCO3 … Continue reading →

Naloxone 100

Naloxone 100

The Good, The Bad & The Ugly Paramedic

MARCH 1, 2021

An accidental opioid overdose and its nemesis, naloxone. Find It In Advance By paying heed to gut instinct and weighing up the pros and cons, we begin to build a clearer picture in the mind around methods to help us manage, or undo, the unwanted effects of interventions. Some start to sink in right from the early days of education.

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Ambulance Paramedic Naloxone First Responder 52

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

He awoke with naloxone. The 50-something patient with history of coronary stenting and slightly reduced LV ejection fraction. He had been smoking an opiate and suddenly collapsed. He was ventilated with BVM on arrival. This EKG was recorded as part of a standing order for critical care. He denied any CP or SOB.

Overdose 52

Overdose OR Coronary ACS 52

Peter Canning

APRIL 18, 2025

We ask what medicine the mom gave him and she hands me what looks like intranasal naloxone. When I started as a paramedic we could only give naloxone intravenously (IV) or intramuscularly (IM). Recently I read the FDA just approved an intranasal epinephrine that also looks just like the naloxone and diazepam nasal sprays.

Epi Pen 52

Epi Pen Naloxone Epinephrine EMT 52

CanadiEM

JANUARY 23, 2024

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. Ken’ is a 47-year-old unhoused man presenting to the Emergency Department (ED) with severe opioid withdrawal symptoms.

Emergency Department 52

Emergency Department ED Naloxone 52

ALiEM

NOVEMBER 29, 2023

Naloxone will not reverse the effects of xylazine; however, it is routinely given in unresponsive or obtunded patients presenting with an opioid toxidrome. In patients with minimal response to naloxone, xylazine toxicity may be suspected [10].

Naloxone 169

Naloxone Overdose ALS Epinephrine 169

The Skeptics' Guide to EM

JANUARY 19, 2019

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. Sixty minutes after receiving naloxone he is GCS 15 and walking to the desk demanding to be discharged.

Naloxone 130

Naloxone Overdose Emergency Medical Services Emergency Department 130

Peter Canning

SEPTEMBER 10, 2024

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.

Naloxone 52

Naloxone EMS Overdose Emergency Medical Services 52

Peter Canning

APRIL 24, 2025

This essential resource provides practical tools to recognize and respond to overdoses, access life-saving treatments like naloxone, and navigate the complex landscape of addiction and recovery. Canning humanizes the crisis through poignant stories of individuals and families grappling with the ripple effects of substance use.

Overdose 52

Overdose Naloxone Paramedic OR 52

REBEL EM

JUNE 5, 2023

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.

Naloxone 95

Naloxone ED Overdose Emergency Department 95

The Skeptics' Guide to EM

AUGUST 27, 2022

He is successfully resuscitated using naloxone and is stable after an observation period. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM. Case: A 24-year-old male presents to the emergency department (ED) after a fentanyl overdose.

Emergency Department 100

Emergency Department Overdose Naloxone ED 100

JEMS

APRIL 8, 2025

The animal tranquilizers xylazine and medetomidine are in approximately one-third of the illegal opioids available in the U.S.

Naloxone 52

Naloxone Overdose NARCAN 52

Peter Canning

SEPTEMBER 19, 2024

In May, I speculated on some of the reasons for declining rates : Harm reduction and the availability of naloxone. Ten years ago when I responded to an overdose, I was the only one carrying naloxone. This doesn’t include all those resuscitations where bystanders gave naloxone and 911 was never called. We know what works!

Naloxone 52

Naloxone Overdose First Responder OR 52

ACEP Now

JULY 7, 2023

While naloxone can treat fentanyl overdose, overdose symptoms may persist when xylazine is involved. Currently, there is no FDA-approved pharmacotherapy for either the reversal of xylazine in humans or the management of withdrawal. Typically, xylazine is mixed with fentanyl.

Overdose 98

Overdose ALS Naloxone Emergency Department 98

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.

Naloxone 52

Naloxone Overdose First Responder NARCAN 52