Opioid overdoses: Emerging clinical challenges

Andrea Ramos, BSN, RN, MSPH; Lina Sarmiento, RN; Noella Dietz, PhD; Nelson Cordero, MD; Ximena Levy, MD-MPH; Charles H. Hennekens, MD, DrPH

doi:10.5055/jom.2020.0561

Authors

Andrea Ramos, BSN, RN, MSPH
Lina Sarmiento, RN
Noella Dietz, PhD
Nelson Cordero, MD
Ximena Levy, MD-MPH
Charles H. Hennekens, MD, DrPH

DOI:

https://doi.org/10.5055/jom.2020.0561

Keywords:

opioid, overdose, emergency

Abstract

Objective: Analysis of a large consecutive case series of cases brought to an Emergency Department (ED).

Design: Retrospective chart review.

Setting: Emergency Department in Broward County, Florida.

Patients: Medical records of patients with registered diagnoses of opioid overdose in 2016 and 2017.

Outcomes: Demographics, toxicology results, mental-health comorbidities, use/response to naloxone, and hospital disposition.

Results: Seven hundred and seventy nine opioid-overdose cases were identified (35 percent female, 65 percent male; age 36.2). Heroin intoxication was registered in 77 percent of discharge diagnoses, and 17.7 percent were prescription pain medications. Urine samples were collected in 39 percent and 81.5 percent of patients received naloxone (mean dose 4.0 mg ± 2.2). Sixty-five percent of cases were discharged home, 17.5 percent left the ED against medical advice, and 17.5 percent were admitted to the hospital/intensive care unit/behavioral unit.

Conclusion: There is an alarming number of visits to the ED due to opioid overdoses with differences in age and gender. Clinicians are facing diagnostic, treatment and follow-up challenges for the management of these cases.

Author Biographies

Andrea Ramos, BSN, RN, MSPH

Emergency Department, North Broward Hospital District d/b/a Broward Health, Fort Lauderdale, Florida

Lina Sarmiento, RN

Emergency Department, North Broward Hospital District d/b/a Broward Health, FortLauderdale, Florida

Noella Dietz, PhD

Director of Research, North Broward Hospital District d/b/a Broward Health, Fort Lauderdale, Florida

Nelson Cordero, MD

Department of Psychiatry & Behavioral Health, North Broward Hospital District d/b/a Broward Health, Fort Lauderdale, Florida

Ximena Levy, MD-MPH

Research Professor, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida

Charles H. Hennekens, MD, DrPH

Sir Richard Doll Professor, Senior Academic Advisor, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida

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