scholarly journals Increases in Naloxone Administrations by Emergency Medical Services Providers During the COVID-19 Pandemic (Preprint)

2021 ◽  
Author(s):  
Dalia Khoury ◽  
Alexander Preiss ◽  
Paul Geiger ◽  
Mohd Anwar ◽  
Kevin Paul Conway
Keyword(s):  
United States ◽  
North Carolina ◽  
Emergency Medical Service ◽  
Medical Service ◽  
The United States ◽  
Opioid Overdose ◽  
Opioid Crisis ◽  
Control Distribution ◽  
Emergency Medical ◽  
Past Data

BACKGROUND The opioid crisis in the United States may be exacerbated by the COVID-19 pandemic. OBJECTIVE The current study examines changes in naloxone administrations during Emergency Medical Service (EMS) runs for opioid-related overdoses during the COVID-19 pandemic in Guilford County, North Carolina. METHODS A period-over-period approach was used to explore EMS data from Guilford County, North Carolina on opioid overdose-related runs. We compared trends in the frequency of opioid-related EMS runs, naloxone administrations (NAs), and multiple naloxone administrations (MNAs) 29 weeks before and during the COVID-19 pandemic. Furthermore, past data were used to generate a quasi-control distribution of period-over-period changes to compare the change observed during the COVID-19 period to each 29-week period back to January 1, 2014. RESULTS All outcomes increased during the COVID-19 period. Compared to the previous 29 weeks, we observed significant proportional increases in mean number of opioid-related EMS runs (37.4%), NAs (57.8%), and MNAs (84.8%). Compared to each previous 29-week period, the COVID-19 period saw increases across all outcomes that were greater than 91% of all past period-over-period changes. CONCLUSIONS The current study is the first to report increases in both incidence (NAs) and severity (MNAs) of opioid overdoses during the COVID-19 pandemic. For a host of reasons that need to be explored, the COVID-19 pandemic appears to markedly increase the occurrence and lethality of the opioid crisis in Guilford County, NC.

Disaster Preparedness

1985 ◽  
Vol 1 (S1) ◽  
pp. 118-121 ◽  
Author(s):  
E. L. Quarantelli
Keyword(s):  
United States ◽  
Natural Disasters ◽  
Emergency Medical Service ◽  
Disaster Preparedness ◽  
Large Scale ◽  
Medical Service ◽  
The United States ◽  
Mass Casualties ◽  
Disaster Plan ◽  
Emergency Medical

The 1973 Emergency Medical Services System Act in the United States mandates that one of the 15 functions to be performed by every EMS system is coordinated disaster planning. Implicit in the legislation is the assumption that everyday emergency medical service (EMS) systems will be the basis for the provisions of EMS in extraordinary mass emergencies, or in the language of the act, during “mass casualties, natural disasters or national emergencies.” Policy interpretations of the Act specified that the EMS system must have links to local, regional and state disaster plans and must participate in biannual disaster plan exercises. Thus, the newly established EMS systems have been faced with both planning for, as well as providing services in large-scale disasters.

The State of Innovative Emergency Medical Service Programs in the United States

2013 ◽  
Vol 18 (1) ◽  
pp. 76-85 ◽  
Author(s):  
Kristy Gonzalez Morganti ◽  
Abby Alpert ◽  
Gregg Margolis ◽  
Jeffrey Wasserman ◽  
Arthur L. Kellermann
Keyword(s):  
United States ◽  
Emergency Medical Service ◽  
Medical Service ◽  
The United States ◽  
The State ◽  
Service Programs ◽  
Emergency Medical

scholarly journals Association Between Emergency Medical Service Response Time and Motor Vehicle Crash Mortality in the United States

JAMA Surgery ◽  
2019 ◽  
Vol 154 (4) ◽  
pp. 286 ◽  
Author(s):  
James P. Byrne ◽  
N. Clay Mann ◽  
Mengtao Dai ◽  
Stephanie A. Mason ◽  
Paul Karanicolas ◽  
...  
Keyword(s):  
United States ◽  
Response Time ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Motor Vehicle ◽  
The United States ◽  
Motor Vehicle Crash ◽  
Vehicle Crash ◽  
Emergency Medical ◽  
Service Response Time

Diabetes-Related Emergency Medical Service Activations in 23 States, United States 2015

2018 ◽  
Vol 22 (6) ◽  
pp. 705-712 ◽  
Author(s):  
Stephen R. Benoit ◽  
Henry S. Kahn ◽  
Andrew I. Geller ◽  
Daniel S. Budnitz ◽  
N. Clay Mann ◽  
...  
Keyword(s):  
United States ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Emergency Medical

scholarly journals Prehospital naloxone administration – what influences choice of dose and route of administration?

2020 ◽  
Author(s):  
Ida Tylleskar ◽  
Linn Gjersing ◽  
Lars Petter Bjørnsen ◽  
Anne-Cathrine Braarud ◽  
Fridtjof Heyerdahl ◽  
...  
Keyword(s):  
Emergency Medical Service ◽  
Medical Service ◽  
Respiratory Arrest ◽  
Route Of Administration ◽  
Patient Treatment ◽  
Opioid Overdose ◽  
Naloxone Administration ◽  
Multiple Doses ◽  
Emergency Medical ◽  
Service Staff

Abstract Introduction:Amidst the ongoing opioid crisis there are debates regarding the optimal route of administration and dosages of naloxone. This applies both for lay people administration and emergency medical services, and in the development of new naloxone products.We examined the characteristics of naloxone administration, including predictors of dosages and multiple doses during patient treatment by emergency medical service staff in order enlighten this debate.Methods: This was a prospective observational study of patients administered naloxone by the Oslo City Center emergency medical service, Norway (2014-2018). Cases were linked to The National Cause of Death Registry. We investigated the route of administration and dosage of naloxone, clinical and demographic variables relating to initial naloxone dose and use of multiple naloxone doses and one-week mortality.Results: Overall, 2,215 cases were included, and the majority (91.9%) were administered intramuscular naloxone. Initial doses were 0.4 or 0.8 mg, and 15% of patients received multiple dosages. Unconscious patients or those in respiratory arrest were more likely to be treated with 0.8 mg naloxone and to receive multiple doses. The one-week mortality from drug-related deaths was 4.1 per 1000 episodes, with no deaths due to rebound toxicity.Conclusions: Intramuscular naloxone doses of 0.4 and 0.8 mg were effective and safe in the treatment of opioid overdose in the prehospital setting. Emergency medical staff appear to titrate naloxone based on clinical presentation.

Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic

2018 ◽  
Vol 1 (21;1) ◽  
pp. 309-326 ◽  
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
United States ◽  
The United States ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Opioid Epidemic ◽  
Synthetic Opioids ◽  
Opioid Crisis ◽  
Electronic Reporting ◽  
Number Of Patients ◽  
Overdose Deaths

The opioid epidemic has been called the “most consequential preventable public health problem in the United States.” Though there is wide recognition of the role of prescription opioids in the epidemic, evidence has shown that heroin and synthetic opioids contribute to the majority of opioid overdose deaths. It is essential to reframe the preventive strategies in place against the opioid crisis with attention to factors surrounding the illicit use of fentanyl and heroin. Data on opioid overdose deaths shows 42,000 deaths in 2016. Of these, synthetic opioids other than methadone were responsible for over 20,000, heroin for over 15,000, and natural and semisynthetic opioids other than methadone responsible for over 14,000. Fentanyl deaths increased 520% from 2009 to 2016 (increased by 87.7% annually between 2013 and 2016), and heroin deaths increased 533% from 2000 to 2016. Prescription opioid deaths increased by 18% overall between 2009 and 2016. The Drug Enforcement Administration (DEA) mandated reductions in opioid production by 25% in 2017 and 20% in 2018. The number of prescriptions for opioids declined significantly from 252 million in 2013 to 196 million in 2017 (9% annual decline over this period), falling below the number of prescriptions in 2006. In addition, data from 2017 shows significant reductions in the milligram equivalence of morphine by 12.2% and in the number of patients receiving high dose opioids by 16.1%. This manuscript describes the escalation of opioid use in the United States, discussing the roles played by drug manufacturers and distributors, liberalization by the DEA, the Food and Drug Administration (FDA), licensure boards and legislatures, poor science, and misuse of evidencebased medicine. Moreover, we describe how the influence of pharma, improper advocacy by physician groups, and the promotion of literature considered peer-reviewed led to the explosive use of illicit drugs arising from the issues surrounding prescription opioids. This manuscript describes a 3-tier approach presented to Congress. Tier 1 includes an aggressive education campaign geared toward the public, physicians, and patients. Tier 2 includes facilitation of easier access to non-opioid techniques and the establishment of a National All Schedules Prescription Electronic Reporting Act (NASPER). Finally, Tier 3 focuses on making buprenorphine more available for chronic pain management as well as for medication-assisted treatment. Key words: Opioid epidemic, fentanyl and heroin epidemic, prescription opioids, National All Schedules Prescription Electronic Reporting Act (NASPER), Prescription Drug Monitoring Programs (PDMPs)

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