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

Paramedics World

JUNE 27, 2024

As more and more highly potent and lethal batches of opioids hit the streets, it’s becoming abundantly clear that the need for high-dosage naloxone is at a critical high. Zimhi… The post Zimhi Injectable Naloxone Is High Dosage but Less Popular Than Inhalers appeared first on Paramedics World.

Naloxone 52

Naloxone Paramedic 52

Paramedics World

JUNE 27, 2024

As more and more highly potent and lethal batches of opioids hit the streets, it’s becoming abundantly clear that the need for high-dosage naloxone is at a critical high. Zimhi… The post Zimhi Injectable Naloxone Is High Dosage but Less Popular Than Inhalers appeared first on Paramedics World.

Naloxone 52

Naloxone Paramedic 52

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?

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Naloxone CPR 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 115

Naloxone OR BLS Overdose 115

EMergucate

JUNE 27, 2012

Naloxone Epinephrine Atropine Lignocaine yes you can !

Naloxone 100

Naloxone Epinephrine 100

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.

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Naloxone ED Overdose Emergency Department 88

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 Naloxone Overdose ED 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.

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NARCAN Naloxone Overdose OR 59

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!

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Naloxone Overdose First Responder OR 52

Peter Canning

MAY 22, 2024

Harm reduction and the availability of naloxone. Ten years ago when I responded to an overdose, I was the only one carrying naloxone. Now, half the time I arrive, the patient is already awake and talking, having gotten their naloxone either from family, bystander, or police or fire first responders. Why are deaths dropping?

Overdose 52

Overdose Naloxone First Responder OR 52

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.

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Naloxone Coronary OR 100

Peter Canning

OCTOBER 1, 2024

Is the decline in drug overdose deaths more related to the increased availability of naloxone, improved treatment for people who use drugs, or changes in the street drug supply, which while still quite toxic may be less so due to adulteration with other chemicals? A recent article in NPR, The pipeline of deadly fentanyl into the U.S.

Overdose 52

Overdose Naloxone OR 52

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

Peter Canning

JANUARY 20, 2024

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. Those efforts should include naloxone distribution, harm reduction information, and access to medication assisted therapy.

Overdose 59

Overdose Naloxone Firefighter First Responder 59

Peter Canning

MARCH 5, 2024

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.

Overdose 52

Overdose Naloxone EMS OR 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?

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Mobile Intensive Care Unit Paramedic Naloxone EMT 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.

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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

Peter Canning

DECEMBER 14, 2024

Widespread naloxone availability, increased harm reduction efforts and a focus on treatment, particularly medication assisted therapy may also be having a large impact on the declining death rate. One thing is clear, fatal drug overdoses are down dramatically in the US and are continuing to drop.

Naloxone 52

Naloxone Overdose OR 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.

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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

Peter Canning

OCTOBER 30, 2023

They overdose behind the dumpster where I give them naloxone and put them in the ambulance. Home became the street, and drugs continued as a way of coping with what lives had become. They use to forget, they use to not be sick anymore. We revive this man and he tells me his story, all too familiar. He used to own his own construction company.

Overdose 52

Overdose BLS EMT EMT 52

ALiEM

OCTOBER 30, 2024

Alternatively, one can cut the 2 mg Suboxone (buprenorphine + naloxone combination) strips into 4 pieces after waiting for a longer washout period (72-96 hours of abstinence from non-medical opioids) before starting the induction. Or one can start methadone induction. Journal of general internal medicine. 2017 Jun;32:660-6.

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

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

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

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

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 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.

Ambulance 52

Ambulance Paramedic Naloxone First Responder 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 →

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