Part 8: Opioid-Associated Life-Threatening Emergencies

You encounter an unresponsive 56-year-old man who has been taking hydrocodone after a surgical procedure. He is not breathing and has no pulse. You notice that his medication bottle is empty. You suspect an opioid-associated life-threatening emergency. A colleague activates the emergency response system and is retrieving the AED and naloxone. What is the most appropriate action for you to take next. (a) wait for the naloxone to arrive before doing anything (b) begin CPR, starting with chest compressions (c) provide 1 rescue breath every 5-6 seconds until naloxone arrives (d) provide rapid defibrillation with the AED

(b) begin CPR, starting with chest compressions

Your 27-year-old roommate uses opioids. You find him unresponsive with no breathing but a strong pulse. You suspect an opioid-associated life-threatening emergency. A friend is phoning 9-1-1 and is looking for the naloxone autoinjector. What action should you take? (a) Remain with your roommate until the naloxone arrives and administers it immediately (b) begin CPR, starting with chest compressions (c) provide rescue breathing: 1 breath every 5-6 seconds (d) provide rapid defibrillation with an AED

(c) provide rescue breathing: 1 breath every 5-6 seconds

What is not an example of an opioid? (a) heroin (b) hydrocodone (c) morphine (d) naloxone

(d) naloxone

examples of opioids are:

-hydrocodone -morphine -heroin (illegal)

What routes can naloxone be given?

-intramuscular -intranasal -intravenous

How can you assess a scene that suggests potential opioid overdose?

1. direct communication with bystanders (ask open questions "does anyone have any info about what happened?") 2. direct observation of the victim: look for signs of injection on the skin or other signs of opioid use 3. observation of the surrounding: look for medication bottle or other signs of opioid use

Describe the steps in an opioid-associated life-threatening emergency sequence

1. verify the scene (do you suspect opioids?) 2. check for responsiveness and get help (send someone to activate emergency response system and get the AED and naloxone) 3. Assess breathing and pulse 4a. If victim is breathing normally and a pulse is present: monitor responsiveness, breathing, and pulse. 4b. If the victim is not breathing normally, but a pulse is present: provide rescue breaths, confirm the emergency response system has been activated, if opioids suspected administer naloxone per protocol and monitor for response, continue rescue breathing and check the pulse about every 2 mins. perform CPRif no pulse. 4c. if the victim is not breathing normally and no pulse is present: provide CPR and use AED asap, if opioids suspected administer naloxone per protocol and monitor response, continue until help arrives or patient responds.

Opioids in high doses can cause

CNS and respiratory depression that can result in respiratory and cardiac arrest

If opioids are taken with other _______ such as alcohol, tranquilizers, or sleeping pills, the risk of respiratory depression is increased, and can be fatal.

CNS depressants

Intranasal naloxone delivers the drug into the nose by using an

atomizer device, a dispenser that release the drug into the nose

Naloxone handheld autoinjectors delivers

a single dose given intramuscularly

If an opioid-associated life-threatening emergency is suspected in patients with a definite pulse, you should

give naloxone to patient

If an opioid-associated life-threatening emergency is suspected in a victim of cardiac arrest, consider

giving naloxone per protocol after starting CPR

An agent that can reverse the effects of respiratory depression caused by opioids

naloxone

Opioids are medications used primarily for:

pain relief

Medications delivered into the nose are quickly absorbed into the bloodstream because

the nasal cavity has a relatively large surface of mucous membranes, which are rich in capillaries and allow fast absorption