Beyond Naloxone: Providing Comprehensive Prehospital Care to Overdose Patients in the Midst of a Public Health Crisis

Providing comprehensive prehospital care to overdose patients Medic 3 arrives on scene to find a 36-year-old male patient supine on the living room floor. The patient is in respiratory arrest and fire department first responders are providing rescue breaths with a bag-valve mask (BVM). The patient has a bounding carotid pulse. A nasopharyngeal airway is placed in the patient’s left nares and the patient is ventilated easily with adequate bilateral lung sounds. The floor is bare wood and the patient is only wearing light undergarments. The ambient temperature in the room is approximately 55 degrees F. The patient’s roommate states that he last saw the patient approximately six hours ago. The crew notes that the patient’s pupils are pinpoint and there is drug paraphernalia surrounding the patient. There is no evidence of trauma. Assessment of the patient’s vital signs reveals a heart rate of 123 beats per minute, blood pressure of 122/86 mmHg, and an oxygen saturation of 98% with assisted ventilation (his room air oxygen saturation was 66%). His initial end tidal CO2 is 70 mmHg and his blood glucose is 269 mg/dL. The patient’s skin is pale, dry and cold to the touch. After establishing IV access and starting a normal saline bolus, the crew administers 0.4 mg of IV naloxone (Narcan). After five minutes, his spontaneous respiratory effort improves and he becomes agitated and combative. The patient’s movement isn’t purposeful and he isn’t able to speak. The patient...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Source Type: news