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. Yes, naloxone works for years after its expiration date. Bottom line: If someone is overdosing and your expired naloxone is all you have, use it.

NARCAN 59

NARCAN Naloxone Overdose OR 59

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 98

Naloxone ED Overdose Emergency Department 98

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. Graphics from CDC

Overdose 52

Overdose Naloxone First Responder OR 52

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.

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Naloxone Overdose Emergency Medical Services Emergency Department 130

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. The most notable problem with this trial is not, in fact, the trial itself.

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Naloxone Emergency Department OR 84

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

Critical Care Scenarios

OCTOBER 11, 2023

Extremity neuro changes should prompt driving the MAP >90, naloxone, and IV steroids. Takeaway lessons We explore aortic dissection with Travis Hughes, vascular surgery fellow from the University of Kentucky, including classification, medical management, and nuances of the surgical perspective. Find us on Patreon here!

Naloxone 100

Naloxone Coronary OR 100

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

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. Pinpoint. in 2020 to 8.6%

Overdose 59

Overdose Naloxone Firefighter First Responder 59

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. .*

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CPR Naloxone Advanced Life Support EMT 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. It does not radiate.

Overdose 52

Overdose OR Coronary ACS 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

Peter Canning

OCTOBER 30, 2023

They overdose behind the dumpster where I give them naloxone and put them in the ambulance. They were injured physically or they were damaged mentally by abuse. They may have true mental health issues, often undiagnosed. They had access to drugs either through a doctor’s prescription or through a friend or the black market. Look at yourself.

Overdose 52

Overdose BLS EMT EMT 52

ACEP Now

JULY 7, 2023

While naloxone can treat fentanyl overdose, overdose symptoms may persist when xylazine is involved. Recently, Philadelphia has been reported as having the highest prevalence of xylazine, with xylazine present in 25.8 percent of all overdose deaths in 2020. Typically, xylazine is mixed with fentanyl.

Overdose 98

Overdose ALS Naloxone Emergency Department 98

EM Basic

MARCH 13, 2019

DISCLAIMER : I’m not doing this episode to discredit those in law enforcement, the fire service, EMS, or any other first responders. I was an EMT-B in southeastern Pennsylvania for 10 years before starting my emergency medicine residency so I know how tough your jobs are on a daily basis. What is “Incidental Exposure”?

Naloxone 52

Naloxone Overdose First Responder NARCAN 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

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

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E-9-1-1 ICU ACS EMS 76

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

Dr. Smith's ECG Blog

MAY 5, 2023

The "good" news — Treatment with naloxone will probably resolve the bradycardia. These mathematical relationships of relative deflection size with absence of any deflection at all in lead I — are most commonly encountered when there is some type of artifact caused by movement or other interference originating from the Left Leg.

E-9-1-1 52

E-9-1-1 NARCAN Naloxone Overdose 52

ALiEM

OCTOBER 30, 2024

The biggest change has been the gradual replacement of diacetylmorphine (heroin) by fentanyl and other synthetic opioids. Along the same time, a veterinary sedative, xylazine , became popular in Puerto Rico in individuals who used injection drugs [3]. We treat with wound care and reserve surgical management only for limbs that are no longer viable.

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

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

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?

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E-9-1-1 ACS OR ICU 125

The Good, The Bad & The Ugly Paramedic

MARCH 1, 2021

An accidental opioid overdose and its nemesis, naloxone. Every intervention that we introduce on emergency calls is intended to make a difference. Improve the situation in one way or another. Some will work and cause an effect that makes things better. Others will not, and may result in making things much worse.

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Ambulance Paramedic Naloxone First Responder 52

ACEP Now

DECEMBER 10, 2023

Though paramedics administered naloxone, he remained somnolent. You ultimately begin a slow naloxone infusion and admit him to the medical ICU. You question yourself for ordering IV potassium and starting a naloxone infusion, knowing you are causing discomfort for the patient who has known significant cancer-related pain.

Naloxone 52

Naloxone Life Support Paramedic ALS 52

AAEM RSA

APRIL 18, 2021

Practices were being implemented to help prevent reckless opioid prescribing and increase availability of naloxone which, to an extent, were working. Availability of lifesaving naloxone is at an all-time high. It wasn’t necessarily easy, but it was familiar. Flash forward to 2020, the year of the COVID-19 pandemic.

Overdose 52

Overdose Naloxone OR 52

Peter Canning

NOVEMBER 9, 2024

This expansion should include patients in prison, many pf whom are in jail due to the substance use disorder and who are at high risk of overdose and death on their release, The US will continue to support harm reduction, including widespread naloxone availability, syringe exchange and the development of overdose prevention sites.

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Naloxone Overdose OR EMS 59