Table 2.
Therapies and ED disposition. UDS urine drug screen, IQR interquartile range
| Any UDS (n = 121) | Fentanyl only (n = 23) | Opiates only (n = 28) | Fentanyl + opiates (n = 70) | |
|---|---|---|---|---|
| Prehospital naloxone route, n (%)a | ||||
| Intranasal | 46 (38) | 5 (22) | 12 (43) | 29 (41) |
| Intramuscular | 30 (25) | 3 (13) | 8 (29) | 19 (27) |
| Intraosseus | 1 (1) | 0 (0) | 0 (0) | 1 (1) |
| Intravenous (IV) | 75 (62) | 19 (83) | 14 (50) | 42 (60) |
| Prehospital naloxone dose, median (IQR, range), mgb | ||||
| Intranasal | 0 (0–0.40, 0–4.80) | 0 (0–0, 0–4.80) | 0 (0–0.40, 0–4.00) | 0 (0–0.40, 0–2.00) |
| Intramuscular | 0 (0–0, 0–2.00) | 0 (0–0, 0–0.80) | 0 (0–0.40, 0–2.00) | 0 (0–0.40, 0–2.00) |
| Intraosseus | 0 (0–0, 0–2.00) | 0 (0–0, 0–0) | 0 (0–0, 0–0) | 0 (0–0, 0–2.00) |
| Intravenous | 0.40 (0–0.80, 0–4.0) | 0.40 (0.40–1.20, 0–4.00) | 0.02 (0–0.40, 0–2.00) | 0.40 (0–0.70, 0–2.50) |
| Total prehospital naloxone, median (IQR), mg IV equivalent | 0.58 (0.40–1.16) | 0.80 (0.40–1.29) | 0.40 (0.36–0.77) | 0.72 (0.40–1.00) |
| ED therapies, n (%) | ||||
| Naloxone < 1 h after arrival | 28 (23) | 5 (22) | 10 (36) | 13 (19) |
| Naloxone > 1 h after arrival | 10 (8) | 0 (0) | 4 (14) | 6 (9) |
| Naloxone infusion | 5 (4) | 1 (4) | 2 (7) | 2 (3) |
| Intubation | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| ED IV naloxone < 1 h after arrival, median (IQR, range), mg | 0 (0–0, 0–2.00) | 0 (0–0, 0–2.00) | 0 (0–0.40, 0–1.20) | 0 (0–0, 0–2.00) |
| Total naloxone dose, EMS + ED resuscitation, median (IQR, range), mg IV equivalent | 0.80 (0.40–1.38, 0.18–5.20) | 0.80 (0.40–1.60, 0.18–5.20) | 0.58 (0.40–1.25, 0.18–2.00) | 0.80 (0.40–1.38, 0.18–3.60) |
| ED disposition, n (%) | ||||
| Against medical advice | 5 (4) | 1 (4) | 0 (0) | 4 (6) |
| Home/self | 74 (61) | 13 (57) | 14 (50) | 47 (67) |
| Observation | 3 (2) | 1 (4) | 0 (0) | 2 (3) |
| Admitted to ward | 33 (27) | 7 (30) | 14 (50) | 12 (17) |
| Admitted to critical care | 6 (5) | 1 (4) | 0 (0) | 5 (7) |
aSome patients received prehospital naloxone via multiple routes. bDose provided in mg as administered, not IV dose equivalent