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http://dx.doi.org/10.1001/jamanetworkopen.2024.29131 | DOI Listing |
Resuscitation
August 2025
Department of Family Medicine and Community Health, Duke University School of Medicine, DUMC 2914 Durham, NC 27710, USA; Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701, USA; Duke University School of Nursing, 307 Trent Dr, Durham, NC 277
Introduction: Opioid-associated out-of-hospital cardiac arrests (OA-OHCA) is a significant problem in the United States. Layperson interventions, including bystander CPR and naloxone may improve survival, but barriers may differ compared to other OHCA. This study aims to describe characteristics of 9-1-1 callers and patients in suspected OA-OHCAs and identify barriers to B-CPR and naloxone administration.
View Article and Find Full Text PDFResusc Plus
September 2025
Division of Prehospital Services, Oslo University Hospital, Oslo, Norway.
Drug overdose is a leading global cause of preventable morbidity and mortality and is closely associated with out-of-hospital cardiac arrest. While the American Heart Association's "chain of survival" has improved outcomes in traditional cardiac arrest, it does not address the unique characteristics and challenges of overdose-related emergencies. In this article, we propose a novel "overdose chain of survival" to emphasize the importance of linking acute care with long-term prevention.
View Article and Find Full Text PDFPrehosp Emerg Care
July 2025
Department of Medicine, University of California, Riverside, Riverside, California.
Objectives: One-in-six cases of atraumatic out-of-hospital cardiac arrest (OHCA) in North America are thought to be precipitated by opioid overdose, but many of these cases are not obvious and there is no gold standard used by emergency medical service (EMS) personnel to identify opioid-associated (OA)-OHCA. The NAloxone Cardiac ARrest Decision Instrument (NACARDI) was developed and validated to identify potential OA-OHCA, however it has not yet been used in the field. We sought to prospectively assess the inter-rater reliability and acceptability of NACARDI in real-world OHCA.
View Article and Find Full Text PDFEmergencias
April 2025
Servicio de Urgencias y Unidad de Toxicología Clínica, Hospital Son Espases, Palma de Mallorca, España.
Objective: To analyze the use of antidotes for street-drug poisonings treated in Spanish emergency departments (EDs), the appropriateness of antidote use in these cases, and adverse events related to antidotes.
Methods: Eleven EDs belonging to the Spanish network for the study of drug poisonings treated in Spanish hospitals (REDUrHE) registered data for patients treated over a period of 24 months. Poisonings exclusively involving alcohol were excluded.
J Emerg Med
May 2025
American College of Medical Toxicology, Phoenix, Arizona.
Background: Fentanyl analogs, such as para-fluorofentanyl (PFF), are increasing in the illicit opioid supply.
Objectives: This study characterizes demographics, clinical effects, and sex differences for naloxone administration in emergency department (ED) patients with confirmed PFF overdose compared with fentanyl.
Methods: This prospective observational cohort is from the ToxIC Fentalog Study between 2020 and 2023 at 10 participating U.