Use of Naloxone in 9-1-1 Patients without Respiratory Depression in Los Angeles County, California (USA).

Abstract

INTRODUCTION:

Along with an increase in opioid deaths, there has been a desire to increase the accessibility of naloxone. However, in the absence of respiratory depression, naloxone is unlikely to be beneficial and may be deleterious if it precipitates withdrawal in individuals with central nervous system (CNS) depression due to non-opioid etiologies.

OBJECTIVE:

The aim of this study was to evaluate how effective prehospital providers were in administering naloxone.

METHODS:

This is a retrospective study of naloxone administration in two large urban Emergency Medical Service (EMS) systems. The proportion of patients who had a respiratory rate of at least 12 breaths per minute at the time of naloxone administration by prehospital providers was determined.

RESULTS:

During the two-year study period, 2,580 patients who received naloxone by prehospital providers were identified. The median (interquartile range) respiratory rate prior to naloxone administration was 12 (6-16) breaths per minute. Using an a priori respiratory rate of under 12 breaths per minute to define respiratory depression, only 1,232 (47.8%; 95% CI, 50.3%-54.2%) subjects who received naloxone by prehospital providers had respiratory depression.

CONCLUSION:

This study showed that EMS providers in Los Angeles County, California (USA) frequently administered naloxone to individuals without respiratory depression.

• Authors: Colin Jenkins, Michael Levine, Stephen Sanko, Clayton Kazan, Caroline E Thomas, Marc Eckstein
• Journal: Prehospital and disaster medicine (Prehosp Disaster Med) Vol. 36 Issue 5 Pg. 543-546 (Oct 2021) ISSN: 1945-1938 [Electronic] United States
• PMID: 34425934 (Publication Type: Journal Article)

Chemical References

• Analgesics, Opioid
• Narcotic Antagonists
• Naloxone

Topics

• Analgesics, Opioid (therapeutic use)
• Drug Overdose (drug therapy)
• Emergency Medical Services
• Humans
• Los Angeles
• Naloxone (therapeutic use)
• Narcotic Antagonists (therapeutic use)
• Respiratory Insufficiency (chemically induced, drug therapy)
• Retrospective Studies