Premium
Assessment for Deaths in Out‐of‐hospital Heroin Overdose Patients Treated with Naloxone Who Refuse Transport
Author(s) -
Vilke Gary M.,
Sloane Christian,
Smith Alan M.,
Chan Theodore C.
Publication year - 2003
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1197/aemj.10.8.893
Subject(s) - medicine , (+) naloxone , heroin , opioid overdose , emergency medicine , drug overdose , population , opioid , retrospective cohort study , medical examiner , emergency medical services , poison control , medical emergency , injury prevention , anesthesia , psychiatry , drug , receptor , environmental health
Naloxone frequently is used to treat suspected heroin and opioid overdoses in the out‐of‐hospital setting. The authors' emergency medical services system has operated a policy of allowing these patients, when successfully treated, to sign out against medical advice (AMA) in the field. Objectives: To evaluate the safety of this AMA policy. Methods: This is a retrospective review of out‐of‐hospital and medical examiner (ME) databases over a five‐year period. The authors reviewed all ME cases in which opioid overdoses were listed as contributing to the cause of death. These cases were cross‐compared with all patients who received naloxone by field paramedics and then refused transport. The charts were reviewed by dates, times, age, sex, location, and ethnicity when available. Results: There were 998 out‐of‐hospital patients who received naloxone and refused further treatment and 601 ME cases of opioid overdose deaths. When compared by age, time, date, sex, location, and ethnicity, there were no cases in which a patient was treated by paramedics with naloxone within 12 hours of being found dead of an opioid overdose. Conclusions: Giving naloxone to patients with heroin overdoses in the field and then allowing them to sign out AMA resulted in no identifiable deaths within this study population.