Overdose Flashcards
What evidence do you need to gather/questions to ask with a suspected OD?
- confirm clinical evidence of substance use/exposure
- identify substances involved collect packaging if possible
- identify route taken e.g. ingested/IV/inhaled
- determine the time substance was taken
- determine the amount of substance taken
- establish what the substance was taken with (e.g. water/alcohol and volume)
- Determine if any intervention prior to AV arrival (e.g. vomiting/naloxone)
What are some short term effects for drug use
- changes in appetite
- consciousness
- HR
- BP
- mood
- AMI
- CVA
- psychosis
- OD
- death
What are some long term effects of drug use?
- heart or lung disease
- Ca
- mental illness
- HIV/AIDS
- Hepatitis
What are some examples of opioids?
- heroin
- morphine
- codeine
- ordine
What are some examples of sedatives?
- GHB
- alcohol
- benzo’s
- volatile agents
What are some examples of TCA’s?
- Amitriptyline
- Norttriptyline
- Dothiepin
What are some examples of psychostimulants?
- Cocaine
- Amphetamine (ice, speed)
- ecstasy
- PCP
What are some signs of a narcotic overdose? (eg. heroin)
- ACS
- pin point pupils
- resp depression
- track marks
When do you transport a narcotic OD?
- after 10 mins if nil response to narcan
- Must be a GCS 15 to leave at home with a responsible person
What are some examples under the “other opioid” arm of the OD CPG?
- endone, morphine, codiene, fentanyl patches, methadone,
What is the treatment for “other opioid” overdose
- assist airway and ventilations
- naloxone 100mcg IV
- ## repeat 100mcg IV every 2/60 (max 2mg) until patient adequately self ventilating
What is the presentation of naloxone?
- 400mcg in 1ml
- if administering IV dilute with 3mls NaCl
Recite the OD Opioid CPG
What are the contraindications for naloxone?
nil significance in above indication
What are some symptoms of withdrawal?
- diaphoresis
- goose flesh
- tremor
- N+V
- Agitation
- dilated pupils
- excessive tearing
- convulsions
if the patient has had a cardiac arrest can you give naloxone?
NO. because MICA cant RSI - unable to give fent/midaz sedation
can you treat and refer a heroin OD?
Yes they must:
- GCS 15 + RR >10
- require only one dose of naloxone
- only have taken heroin
- no other causes (hypoglycaemia, infection, trauma)
- not have had any seizure activity
- not be pregnant
- not a risk to self/others
What are some symptoms of mild to moderate TCA OD?
- drowsiness, confusion
- tachycardia
- slurred speech
- hyperreflexia
- ataxia
- mild HTN
- dry mucous membranes
- resp depression
What are some symptoms of severe TCA OD? (within 6 hrs of ingestion)
- Coma
- resp depression/hypoventilation
- conduction delays
- PVC’s
- SVT
- VT
- hypotension
- seizures
- ECG changes
What cardiac effects does TCA OD have?
- HTN
- tachycardia
- orthostasis
- hypotension
- arrythmias (VT, VF)
- ECG changes (block the fast sodium channels = wide QRS, block the K+ channels = prolonged QT)
How do you measure a prolonged QT interval manually?
> 1/2 R-R interval
Recite the TCA OD CPG
What does AEIOUTIPS stand for?
- alcohol/drug intoxication
- Epilepsy (post ictal)
- Insulin or metabolic cause hypo/hyperglycaemia, renal/liver failure
- Overdose/oxygen (hypoxia)
- Underdose (alcohol/drug withdrawal)
- Toxins
- Infection/Sepsis
- Pain/psychiatric condition
- Stroke/TIA
What does AEIOUTIPS stand for?
- alcohol/drug intoxication
- Epilepsy (post ictal)
- Insulin or metabolic cause hypo/hyperglycaemia, renal/liver failure
- Overdose/oxygen (hypoxia)
- Underdose (alcohol/drug withdrawal)
- Toxins
- Infection/Sepsis
- Pain/psychiatric condition
- Stroke/TIA
