دورية أكاديمية
أعرض في EDS

Outcomes of Out-of-Hospital Cardiac Arrest Patients Who Received Naloxone in an Emergency Medical Services System With a High Prevalence Of Opioid Overdose.

التفاصيل البيبلوغرافية
العنوان: Outcomes of Out-of-Hospital Cardiac Arrest Patients Who Received Naloxone in an Emergency Medical Services System With a High Prevalence Of Opioid Overdose.
المؤلفون: Quinn E; Maimonides Medical Center, Brooklyn, New York. Electronic address: equinn@maimonidesmed.org., Murphy E; Cooper Medical School, Camden, New Jersey., Du Pont D; University of Pennsylvania Health System, Philadelphia, Pennsylvania., Comber P; Cooper Medical School, Camden, New Jersey., Blood M; Cooper Medical School, Camden, New Jersey., Shah A; Cooper Medical School, Camden, New Jersey., Kuc A; Cooper Medical School, Camden, New Jersey., Hunter K; Cooper Medical School, Camden, New Jersey., Carroll G; Cooper Medical School, Camden, New Jersey.
المصدر: The Journal of emergency medicine [J Emerg Med] 2024 Sep; Vol. 67 (3), pp. e249-e258. Date of Electronic Publication: 2024 Apr 09.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 8412174 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0736-4679 (Print) Linking ISSN: 07364679 NLM ISO Abbreviation: J Emerg Med Subsets: MEDLINE
أسماء مطبوعة: Publication: <2010>- : New York : Elsevier
Original Publication: New York : Pergamon Press, c1983-
مواضيع طبية MeSH: Naloxone*/therapeutic use , Out-of-Hospital Cardiac Arrest*/drug therapy , Emergency Medical Services*/methods , Emergency Medical Services*/statistics & numerical data , Narcotic Antagonists*/therapeutic use , Opiate Overdose*/drug therapy, Humans ; Male ; Female ; Middle Aged ; Aged ; Prevalence ; Adult ; Logistic Models ; Drug Overdose/drug therapy
مستخلص: Background: Opioid-associated out-of-hospital cardiac arrest (OA-OHCA) is a subset of cardiac arrests that could benefit from measures outside of standard Advanced Cardiac Life Support (ACLS), such as naloxone.
Study Objectives: In this study, we sought to examine whether OHCA patients chosen for naloxone therapy by emergency medical services (EMS) clinicians in a system with high rates of opioid overdose would have increased rates of return of spontaneous circulation (ROSC) and survival to hospital discharge.
Methods: The study took place in an urban EMS system with a high prevalence of opioid overdose. Paramedics could administer naloxone in cardiac arrest in addition to ACLS. It was often administered based on clinical gestalt for suspected OA-OHCA. The outcomes of OHCA patients who received naloxone were compared against those who received usual care in both an adjusted and unadjusted fashion. Lastly, we created a logistic regression model to test for an independent association of naloxone administration on ROSC and survival to hospital discharge.
Results: A consecutive sample of 769 OHCA patients was obtained, of which 175 (23%) received naloxone. On average, patients who received naloxone had significantly fewer comorbidities and were younger. There was no difference in ROSC, survival to hospital discharge, or modified Rankin Scores. Using logistic regression modeling, there was no statistically significant effect of naloxone administration on these outcomes.
Conclusion: OHCA patients who received naloxone, despite being younger and having fewer comorbidities, had similar outcomes compared to those who received usual care. The difference in baseline characteristics suggests that paramedic gestalt reasonably selected for OA-OHCA.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Eric Quinn, Emily Murphy, Daniel Du Pont, Paul Comber, Marley Blood, Aman Shah, Alexander Kuc, Krystal Hunter, and Gerard Carroll were all employed by the academic health system where this study took place. The authors have no other financial, personal, or competing interests to declare.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Advanced Life Support; emergency medical services; naloxone; opioid associated out-of-hospital cardiac arrest; out-of-hospital cardiac arrest
المشرفين على المادة: 36B82AMQ7N (Naloxone)
0 (Narcotic Antagonists)
تواريخ الأحداث: Date Created: 20240721 Date Completed: 20240826 Latest Revision: 20240826
رمز التحديث: 20240827
DOI: 10.1016/j.jemermed.2024.03.038
PMID: 39034160
قاعدة البيانات: MEDLINE
الوصف
تدمد:0736-4679
DOI:10.1016/j.jemermed.2024.03.038