23 y/o male overdose

[Exp. Hatam]

You respond to the scene of a 23 year old male who has overdosed in his house. He is lying on the couch with respiration of 4 BPM. You and your partner lift him onto the floor. Next, would you:

A) Provide 95% O2 via Nonrebreather mask

B) Provide 6 LPM O2 via nasal cannula

C) Provide 100% O2 via BVM

D) None of the Above

 

[Carlos Danger]

A.

Plus 200 mcg of nalaxone. Then switch the NRB for a NC or room air once Sp02 gets above 90%

What did I win?

P.S. If this was a homework question, tell your instructor he doesn't know what he's doing.

 

[Exp. Hatam]

Why wouldn't the BVM be used?

 

[DesertMedic66]

Why wouldn't the BVM be used?

You tell us

 

[Exp. Hatam]

The BVM is used for a non-breathing patient.

My book says that the BVMs could also be used to ventilate patients with inadequate respirations (e.g. drug overdose).

 

[DesertMedic66]

So then what would you do for this patient?

 

[NomadicMedic]

Sounds like a basic question (i.e.: no Narcan) so it would be C with an ALS intercept for Narcan.

 

[medichopeful]

A.

Plus 200 mcg of nalaxone. Then switch the NRB for a NC or room air once Sp02 gets above 90%

What did I win?

P.S. If this was a homework question, tell your instructor he doesn't know what he's doing.

NRB with a respiratory rate of 4? Also, nothing necessarily says this is an opiate overdose. Likely? Depends. But could be benzos, multisubstance,etc.

 

[gotbeerz001]

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[cprted]

Patient found down, shouldn't assume this is an overdose at all. Lots of other differentials to consider ...

 

[Fleury14]

OPA, assist ventilations with a bvm for 2 minutes, narcan, continue assisting w/bvm until he wakes up... Simple BLS call.

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[medichopeful]

OPA, assist ventilations with a bvm for 2 minutes, narcan, continue assisting w/bvm until he wakes up... Simple BLS call.

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I would be careful with an OPA. NPA maybe, but I would be concerned about vomiting.

 

[Carlos Danger]

NRB with a respiratory rate of 4? Also, nothing necessarily says this is an opiate overdose. Likely? Depends. But could be benzos, multisubstance,etc.

The OP said it was an OD.

What besides opioids causes a RR of 4?

 

[Fleury14]

I would be careful with an OPA. NPA maybe, but I would be concerned about vomiting.

Always OPA first in that situation.

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[medichopeful]

The OP said it was an OD.

What besides opioids causes a RR of 4?

Benzos and alcohol can both cause respiratory depression. I'll give it to you it's most likely an opiate, but other substances can cause respiratory depression or arrest.

 

[medichopeful]

Always OPA first in that situation.

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What's your thinking on that? I'm legitimately curious.

 

[DesertMedic66]

Always OPA first in that situation.

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Why always?

 

[Fleury14]

Ok maybe with some kind of oral trauma but otherwise why wouldn't you try to use the opa first?

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[DesertMedic66]

Ok maybe with some kind of oral trauma but otherwise why wouldn't you try to use the opa first?

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If you're an ALS unit Narcan. There is still a decent possibly of an intact gag reflex

 

[Carlos Danger]

Benzos and alcohol can both cause respiratory depression. I'll give it to you it's most likely an opiate, but other substances can cause respiratory depression or arrest.

And that's the whole point