opioid toxicity
| Headline | |
|---|---|
| History | |
| Examination | |
| Diagnostic investigations | |
| Differentials | |
| Immediate management | RR 6-10 and SpO2 86-92% on air: RCEM advocates 100-200mcg naloxone boluses RR <5 and/or SpO2 <85% on air: treat as resp/peri-arrest. Ventilate, naloxone 400mcg → 800 → 800 → 2000mcg IV. If no response, consider alternative diagnosis |
| Ongoing management | Naloxone infusion should be started at about 60% of total dose naloxone required to reverse resp depression Aim RR >10 Continue infusion at least 4h - titrated by 25% of the maximum infusion rate every tw |