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

Published online by Cambridge University Press:  24 August 2021

Colin Jenkins Open the ORCID record for Colin Jenkins [Opens in a new window] ,
Michael Levine ,
Stephen Sanko ,
Clayton Kazan ,
Caroline E. Thomas  and
Marc Eckstein
Colin Jenkins
Affiliation:
Keck School of Medicine, University of Southern California, Los Angeles, CaliforniaUSA
Michael Levine*
Affiliation:
Department of Emergency Medicine, University of California, Los Angeles, Los Angeles, CaliforniaUSA
Stephen Sanko
Affiliation:
Department of Emergency Medicine, University of Southern California, Los Angeles, CaliforniaUSA Los Angeles City Fire Department, Los Angeles, CaliforniaUSA
Clayton Kazan
Affiliation:
Los Angeles County Fire Department, Los Angeles, CaliforniaUSA
Caroline E. Thomas
Affiliation:
Southbank International School, Westminster, London, United Kingdom
Marc Eckstein
Affiliation:
Department of Emergency Medicine, University of Southern California, Los Angeles, CaliforniaUSA Los Angeles City Fire Department, Los Angeles, CaliforniaUSA
*
Correspondence: Michael Levine, MD Department of Emergency Medicine University of California, Los AngelesLos Angeles, CaliforniaUSA E-mail: michaellevine@mednet.ucla.edu
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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.

Keywords

Emergency Medical Servicesnaloxoneopioidoverdoserespiratory depression
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 5 , October 2021 , pp. 543 - 546
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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