Opioid Toxicity

You suspect your patient is suffering from opioid toxicity. What are the indications? [[Altered LOC OR Respiratory depression OR Inability to adequately ventialate OR Suspected opioid overdose->Wrong1]] [[Altered LOC AND Resipiratory depression AND Inability to adequately ventilate AND Suspected opioid overdose->Correct1]]

WRONG! [[Try again->Start]]

Ok, what drug would you like to give? [[Epinephrine->Wrong1]] [[Salbutamol->Wrong1]] [[Epinephrine Auto Injector->Wrong1]] [[NaCL Fluid Bolus->Wrong1]] [[Nitroglyercin->Wrong1]] [[ASA->Wrong1]] [[Acetominophen->Wrong1]] [[Ketorolac->Wrong1]] [[Ibuprophen->Wrong1]] [[Naloxone->Correct2]]

What are the conditions for Naloxone? [[Age: N/A LOA: Unaltered HR: N/A RR: N/A SBP: Normotensive Other: N/A->Wrong1]] [[Age: <=16 LOA: Unaltered HR: N/A RR: <10/min SBP: N/A Other: No RVI on ECG->Wrong1]] [[Age: >=18 LOA: Altered HR: N/A RR: <10/min SBP: N/A Other: N/A->Correct3]]

Which is NOT a contraindication for Naloxone? [[Uncorrected hypoglycemia->Wrong1]] [[Allergy or sensitivity to naloxone->Wrong1]] [[Hypertensive emergency->Correct4]]

Before we give the drug what else do we need to do? [[Patch to base hospital for authorization->Correct5]] [[12 lead acquisition->Wrong1]] [[Give epinephrine first->Wrong1]]

Dosage for SC, IM, IN, IV [[You give one single dose of the max 0.8 mg no matter what route you choose.->Wrong1]] [[You give one single dose of the max 0.8 mg for all routes except IV. IV dosage is 'Up to 0.4 mg' with a max dose of 0.4 mg.->Correct6]] [[You give one single dose of the max 8 mg no matter what route you choose.->Wrong1]] [[You give multiple doses of 0.1 mg per kg for all routes except IV. IV dosage is 'Up to 0.8 mg' with a max dose of 0.8 mg.->Wrong1]]

Remember: For the IV route you should titrate naloxone only to restore the patient's respiratory status. Naloxone may unmask alternative toxidromes in mixed overdose situations (leading to: possible seizures, hypertensive crisis, etc) Naloxone is shorter acting then many narcotics and these patients are at high risk of having a recurrence of the narcotic effect. Therefore, every effort should be made to transport the patient to hospital for ongoing monitoring. If there is a refusal of transport initiated by the patient ensure safe monitoring by an available, reliable individual. Combative behaviour should be anticipated following naloxone administration and paramedics should protect themselves accordingly. BVM with basic airway management and oxygenation are preferred over naloxone administration.