Emergency Medicine Cases

OCTOBER 23, 2018

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.

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Overdose Emergency Management Emergency Manager Naloxone 130

ALiEM

NOVEMBER 29, 2023

Recently, xylazine has gained attention in the media with increasing reports of xylazine-related overdose deaths in patients. When combined with illicit opioids such as heroin and fentanyl, xylazine may increase the risk of fatal overdose given the augmented sedation and respiratory depression effects [2]. Published May 2023.

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Naloxone Overdose Epinephrine ALS 169

Peter Canning

MARCH 5, 2024

Opioid deaths represented 92% of all overdose deaths in Connecticut. Fentanyl was present in 92% of opioid deaths and 85% of all overdose deaths. In 2023, cocaine was present in 54% of all overdose deaths and 55% of all fentanyl deaths. In 2023, xylazine presence in fatal overdoses decreased by 8% to 286.

Overdose 52

Overdose Naloxone EMS OR 52

Peter Canning

SEPTEMBER 19, 2024

overdose deaths plummet, saving thousands of lives, blared the headline from NPR yesterday. 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. We know what works!

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Naloxone Overdose First Responder OR 52

REBEL EM

JUNE 5, 2023

Background Information: Opioid overdose deaths have been increasing in the past twenty years. The national number of overdose deaths from any opioid has increased 62.5% In addition, buprenorphine has a lower risk of death from overdose when compared to methadone (2). Initial doses ranged between 0.2 PMID 33392580.

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Naloxone ED Overdose Emergency Department 98

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. The EMS crew observes drug paraphernalia and suspect an intravenous (IV) opioid overdose.

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Naloxone Overdose Emergency Medical Services Emergency Department 130

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

The Skeptics' Guide to EM

AUGUST 27, 2022

Case: A 24-year-old male presents to the emergency department (ED) after a fentanyl overdose. He is successfully resuscitated using naloxone and is stable after an observation period. You are interested in seizing this opportunity to offer some type of help to this patient to prevent another opioid overdose in his future.

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Emergency Department Naloxone Overdose ED 100

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. Rest, you overdosed. We had to give you naloxone. We had to give you naloxone. He overdosed?” We gave him a little naloxone and he came around. You should have naloxone in your house.

Naloxone 52

Naloxone Overdose NARCAN 52

EMDocs

NOVEMBER 6, 2023

Opioid overdose remains the leading cause of cardiac arrest due to poisoning in North America. Naloxone administration may reverse respiratory arrest, preventing progression to cardiac arrest. Editorial Comment: Naloxone first, flumazenil only for pure benzo’s (e.g., COR No Benefit, LOE C-EO. COR Harm, LOE B-R.

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Naloxone OR Overdose BLS 95

ACEP Now

JULY 7, 2023

Xylazine is a veterinary sedative that has been increasingly implicated in overdose deaths throughout the United States. percent of all overdose deaths in 2020. 1 Known by street names such as “tranq,” “tranq-dope,” or “zombie drug,” xylazine is increasingly found in patients with opioid overdose. Drug and Alcohol Dependence.

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Overdose ALS Naloxone Emergency Department 98

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

Peter Canning

OCTOBER 30, 2023

We’re dispatched to an overdose on Ashley Street. I have done many overdoses like this one of homeless people who were in fact down alleys and behind dumpsters. They appeared in court or were hospitalized for overdose. They overdose behind the dumpster where I give them naloxone and put them in the ambulance.

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Overdose BLS EMT EMT 52

Prehospital Emergency Care Podcast

MAY 21, 2021

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 (..)

Naloxone 52

Naloxone Overdose EMS 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.

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CPR Naloxone Advanced Life Support EMT 52

EMOttawa

MARCH 28, 2024

Over the past 10 years, opioid overdoses and deaths have continued to climb in Ontario, now surpassing the annual death toll from road traffic accidents. Opioid use disorder is a terrible disease that takes over people’s lives and leaves them overwhelmed, consumed by compulsions and cravings, and often alone.

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Overdose Naloxone 67

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.

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Overdose OR Coronary ACS 52

EM Basic

MARCH 13, 2019

Today’s episode of the podcast is a myth busting on all the media reports about first responders overdosing by being exposed to fentanyl in the field by incidental contact. 100 micrograms is not enough to cause an overdose in an adult. Even if you were to try to overdose on fentanyl patches this is next to impossible.

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Naloxone Overdose First Responder NARCAN 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 (..)

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Overdose ED EMS Naloxone 130

Dr. Smith's ECG Blog

MAY 5, 2023

Krantz et al authored a State-of-the-Art Review on Cardiovascular Complications of Opioid Use ( JACC 77(2):205-223, 2021 ) — in which mechanisms from Opioid Overdose that detail arrhythmia production ( up to cardiac arrest ) are elucidated — thereby providing an explanation for the unusual arrhythmias in today's case.

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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.

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Emergency Department ED Naloxone ALS 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.

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Ambulance Paramedic Naloxone First Responder 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. In 2018, drug overdose deaths dropped for the first time in 20 years. In 2018, drug overdose deaths dropped for the first time in 20 years. Unfortunately, not right at all.

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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