string(11) "/protocols/"

OVERDOSE 16.0

All Providers

  • Focused history and physical exam
    • Assess blood glucose, temperature, and oxygen saturation
  • Assess the time and circumstances of the ingestion
  • Assess scene for additional information on toxins, poisons, medications or other concerns
  • Cardiac monitor, ETCO2, pulse oximetry
  • Treatment Plan
    • Consider 12 lead EKG
    • Patients who have attempted suicide CANNOT be released without transport. Law enforcement may need to assist in ensuring transport.
Key Considerations
  • Transport any pills, bottles, open containers, or potential chemicals that may have been ingested
  • Transport any notes or other pre-ingestion communications

Adult

EMT
  • Naloxone 0.4-2 mg (per dose) IN for suspected narcotic overdose
  • May repeat q 5 minutes as needed for respiratory depression
  • Consider advanced airway
AEMT
  • Vascular access and fluid therapy per IV/IO Access and Fluid Therapy protocol
  • Naloxone 0.4-2 mg (per dose) IV/IM/IO/IN for suspected narcotic overdose
  • May repeat q 5 minutes as needed for respiratory depression
Paramedic
  • Contact OLMC
    • Sodium bicarbonate 1 meq/kg slow IV/IO push for tricyclic antidepressant overdose with sustained HR>120, hypotension unresponsive to fluids, or ventricular dysrhythmias
    • Epinephrine (1:1000) 2-10 mcg/min IV/IO infusion for hypoperfusion.Titrate to maintain MAP >60 mmHg

Pediatric
not to exceed adult dose

EMT
  • Naloxone 0.1 mg/kg IN for suspected narcotic overdose
  • May repeat q 5 minutes as needed for respiratory depression
  • Consider advanced airway
AEMT
  • Vascular access and fluid therapy per IV/IO Access and Fluid Therapy protocol
  • Naloxone 0.1 mg/kg (max 2 mg per dose) IV/IM/IO/IM for suspected narcotic overdose
  • May repeat q 5 minutes as needed for respiratory depression
Paramedic
  • Contact OLMC
    • Epinephrine (1:1,000) 0.1-2 mcg/kg/min IV/IO infusion for hypoperfusion. Titrate to maintain SBP>70 + (age in years X 2) mmHg