We do!Anyone have intranasal narcan?
As for the OP's question - I take it as I see it. Sometimes I'll push it as a "why not", often I don't. It depends on the actual call. If it's "grandma won't wake up" at the SNF, if Grandma isn't covered in Fentanyl patches, I'm probably not going to push it "just because". If my patient is found down on the street at 3am Saturday with no obvious trauma and apnea? They'll get a dose on the way to the trauma center.My question to you is how freely do you use naloxone in the treatment of patients with an acute presentation of ALOC? Mainly in a scenario where you can't rule in or rule out narcotics as the cause. I ask because I have always been one to use naloxone only if they are altered with - known narcotic use, respiratory depression, or significant papillary findings. The new partner I am working with likes to use it on every patient who is altered with unknown etiology. Thoughts?
so I can wake up the OD patient with some naloxone and they can walk down the 3 flights of stairs to the waiting cot under their own power, or I can hurt my back carrying said OD patient down to the cot..... quick someone grab me the Naloxone!!!Why would you give an ALOC patient with no respiratory depression Naloxone anyway? A patient not in opioid withdrawal is a comfortable and complaint patient.
so I can wake up the OD patient with some naloxone and they can walk down the 3 flights of stairs to the waiting cot under their own power, or I can hurt my back carrying said OD patient down to the cot..... quick someone grab me the Naloxone!!!
Different systems seem to have different answers to this situation. It seems like places that see a lot of opiate ODs often encourage their providers to use large doses of narcan and "treat and release". This was less common where I worked.
Or just wait a little longer till they become unconscious again because the half-life of Narcan is less than that of the drugs it reverses.