BVM and naloxone administration may prevent need for intubation
May repeat Naloxone q3min up to max dose 10mg. It has an almost immediate onset of action with a duration of action = 20-90min (depending on the drug ingested, most overdoses especially from heroin will require repeat dosing of Naloxone)
If apneic or near-apneic - 2mg IV
If opioid-naive with minimal respiratory depression - 0.4mg IV
If opioid-dependent with minimal respiratory depression - 0.05mg IV ("push dose Narcan")
Infusion
Only give if patient responded to the bolus and requiring repeat administration
Step 1: Determine the "wake-up dose" or bolus required to wake the patient
Step 2: Give 2/3 of the "wake-up dose" per hr; mix in 1L D5W
Only give if patient responded to the bolus and requiring repeat administration
Step 1: Determine the "wake-up dose" or bolus required to wake the patient
Step 2: Give 2/3 of the "wake-up dose" per hr; mix in 1L D5W
Activated charcoal x1 if opioid ingestion occurred within 1hr
Opioid toxicity
Clonidine toxicity
Benzodiazepine toxicity
Organophosphate toxicity
Opioid withdrawal
CO poisoning
Marijuana toxicity
Hypoglycemia