Online Program

A Single County Quality Assurance Outcomes Review of a Basic Life Support Pilot Program for Opioid Overdose Treatment Using Intranasal Naloxone

Tuesday, November 3, 2015 : 2:50 p.m. - 3:10 p.m.

Emma Furlano, School of Medicine, Stony Brook University School of Medicine, Albany, NY
Michael Dailey, MD, Department of Emergency Medicine, Albany Medical Center, Albany, NY
Robert Delagi, MA, NREMT-P, Suffolk County Department of Health Services Regional EMS Program Agency, Yaphank, NY
Objectives: To evaluate the outcomes of patients treated with intranasal naloxone for opioid overdose through a basic emergency medical technician pilot program.

Methods: We performed a retrospective analysis of consecutive patients who received BLS naloxone through the NYS BLS pilot project. Quality assurance data reviewed included patient care reports (PCRs), program administration forms, and hospital records.

 Results: Analysis was performed on complete records. Of 139 administrations, 81 records were complete to hospital discharge. Per protocol, 96% of the patients had presentations appropriate for naloxone administration. 90% of patients had opioid-related hospital discharge diagnosis; 8 patients did not. However, for several the EMS documentation indicated opioid ingestion even though the hospital discharge diagnosis did not. Average length of stay in the Emergency Department (ED) was 7.1 hours (86% of patients) and 72.5 hours (14% of patients) if admitted. 79% were discharged home, 14% were admitted, and 7% left against medical advice from the ED. 37% received directed discharge planning specific to opioid overdose prevention by receiving educational materials (2.5%), referrals to outpatient addiction programs (27%), and direct enrollment into outpatient rehabilitation (7.4%).

Conclusion: Naloxone is a safe, effective way to reverse an opioid overdose that BLS providers can accurately and appropriately administer. Expanding the use of naloxone to all EMS responders allows for safe and rapid opioid overdose treatment for patients without immediate access to advanced life support providers. Hospitals should work to continue to increase opportunities to direct people that overdose to addiction and overdose prevention resources at discharge.

Learning Areas:

Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health

Learning Objectives:
Evaluate the signs and symptoms of an opioid overdose. Identify the indications and contraindications for intranasal naloxone usage. Explain how to effectively administer intranasal naloxone. Discuss emergency department addiction recovery resources for opioid overdose patients.

Keyword(s): Drug Abuse, Treatment Efficacy

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Naloxone was used intranasally and off label in this state department of health approved pilot project. We are reporting on the results of this pilot project.

Qualified on the content I am responsible for because: I completed an internship at the Suffolk County Department of Health Services in partnership with Albany Medical Center (AMC) during which I performed a quality assurance assessment of naloxone usage by EMS providers. I also published a magazine article in EMS World focusing on intranasal naloxone. I am actively pursuing the study of opioid overdose treatment in conjunction with AMC. My interests include recreational drug overdose treatment and drug abuse prevention, especially in at-risk populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.