Podcast 602: Post-Narcan Observation

<p><strong>Contributor: Donald Stader, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">Not uncommon for patients presenting after opiate overdose and narcan administration to be observed for 4-6 hours</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">This has been based more on tradition than evidence</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Observation periods for overdose may vary based on the opiate(s) used</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Fentanyl and heroin have half lives of about 2 hours, while oxycodone and methadone have significantly longer half lives. </span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">HOUR trial attempted to externally validate a scoring tool</span> <span style="font-weight: 400;">for stratification of low risk patients appropriate for discharge after 1 hour</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Clemency BM, Eggleston W, Shaw EW, Cheung M, Pokoj NS, Manka MA, Giordano DJ, Serafin L, Yu H, Lindstrom HA, Hostler D.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/30592101/"><span style= "font-weight: 400;">Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study.</span></a> <span style="font-weight: 400;">Acad Emerg Med. 2019 Jan;26(1):7-15. doi: 10.1111/acem.13567. Epub 2018 Dec 28. PMID: 30592101.</span></span></p> <p><span style="font-size: 10pt;"><em><span style= "font-weight: 400;">Summarized by Will Dewispelaere, MD | Edited by Erik Verzemnieks, MD</span></em></span></p> <p><br /> <br /></p>