Lesson 6: Opioid Overdose

Cyanosis.

Bluish discoloration of the skin and mucous membranes.

What is the correct ventilation rate for an adult patient in respiratory arrest?

1 ventilation every 5 to 6 seconds

You should immediately request an AED and _______regardless of whether Liz is in respiratory or cardiac arrest. When opioid overdose is suspected, request naloxone at the same time as the AED.

a BVM (or pocket mask) the AED

How much naloxone is given?

Administering 2 mg of naloxone intranasally.

How long should you wait before administering it?

4 min Yes, that's correct. You should wait 4 minutes before administering the second dose. The recommended dose is 2 mg intranasal or 0.4 mg intramuscular. If the naloxone is premeasured, administer the entire dose. You may repeat the dose every 4 minutes if Liz does not respond. If she has a pulse but is not breathing, continue to deliver ventilations. If she has no pulse and is not breathing, continue to perform CPR. It can sometimes take a few minutes for the medication to be completely absorbed.

When to stop ventilation?

After 2 min

Other indicators of opioid overdose include

Cyanosis (Track marks from intravenous drug use) Prescription pill bottles, pipes, needles, syringes, pill powder or other drug-related items. History of opioid drug abuse.

An adult patient with a suspected opioid overdose is in respiratory arrest. Which of the following actions are most appropriate?

-Administer naloxone, if your facility's protocol allows. -Check the pulse and breathing about every 2 minutes. -Provide 1 ventilation every 5 to 6 seconds.

A young adult is brought into the emergency department by his mother. After completing a rapid assessment, you determine the patient is in cardiac arrest related to an opioid overdose. While the team initiates CPR, you prepare to administer naloxone. Which route(s) would be most appropriate to administer the naloxone?

Intranasal Intravenous Intramuscular

_________ can be used to temporarily reverse the respiratory depression or arrest caused by opioid overdose.

Naloxone

A patient is suspected of an opioid overdose. Which findings would most likely support this suspicion?

Pinpoint pupils Unconsciousness Respiratory depression

If the patient responds to the naloxone, you need to be prepared to perform which action(s) most immediately?

Protect yourselves against a possible violent reaction from Liz, clear the airway if needed and put Liz into a recovery position.

You open the patient's airway and look, listen, and feel for breathing while simultaneously checking for a carotid pulse. The patient has a pulse but is not breathing. Which action is the priority?

Provide care for respiratory arrest, starting with ventilations. That's right. Liz is in respiratory arrest, so you and the team should immediately deliver ventilations. Liz does not need chest compressions since she is not in cardiac arrest. Administration of naloxone is important, but remember delivering ventilations is the priority over administering naloxone during respiratory arrest.

A normal ETCO2 value rules out ____________

Respiratory depression

You pause ventilations and check for ______You note that Liz is not breathing normally and does not have a pulse. You initiate_____ and Kara sets up the AED.

breathing and a pulse CPR

When assessing a patient with suspected or known opioid overdose, consider the use of more objective assessments to assess breathing, such as__________

capnography

You open the patient's airway and look, listen, and feel for breathing while simultaneously checking for a ________ The patient has a pulse but is not ____

carotid pulse breathing

opioid overdose triad:

coma, respiratory depression, pinpoint pupils Pinpoint pupils Respiratory depression Unconsciousness or severe sleepiness

Opioid overdose- associated fatalities can be prevented if you provide basic life support care and immediately administer _________when opioid overdose is suspected.

naloxone

The administration of ________ is recommended during both respiratory and cardiac arrest.

naloxone

Patients who respond after _____frequently vomit and may even become ____ Immediately, you should prepare to clear Liz's airway, while keeping your safety in mind. It is not necessary to restrain Liz, and it is often dangerous to do so. Finding out which substances or medications she may have used or ingested is important, but not a priority while she is regaining consciousness.

naloxone violent.

That's right. The opioid overdose triad consists of _____________

pinpoint pupils, respiratory depression, and unconsciousness or severe sleepiness.

When Liz does not immediately respond to the naloxone, you and Kara continue with CPR and AED use. Jamal prepares to deliver a _________

second dose