Emergency Medical Services Naloxone Administration: Many Unknowns and Opportunities
Authors: Elizabeth M. Oliva, Mark Bounthavong
Journal: Annals of Internal Medicine (2017)

Editorials19 December 2017Emergency Medical Services Naloxone Administration: Many Unknowns and OpportunitiesElizabeth M. Oliva, PhD and Mark Bounthavong, PharmD, MPHElizabeth M. Oliva, PhDVA Program Evaluation and Resource Center, Office of Mental Health and Suicide Prevention, VA Center for Innovation to Implementation, Menlo Park, California (E.M.O.)Search for more papers by this author and Mark Bounthavong, PharmD, MPHVHA Pharmacy Benefits Management Services, Academic Detailing Service, Seattle, Washington (M.B.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-2963 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Chou and colleagues' systematic review of management of suspected opioid overdose with naloxone in out-of-hospital settings (1) is both timely and eye-opening. The title may be a misnomer given that the review focused on a single out-of-hospital setting (emergency medical services [EMS]) and included a study conducted in an Iranian emergency department. Delineating the focus of the review is important because there is great interest in other out-of-hospital settings, including those that equip first responders (for example, law enforcement officers and firefighters) and layperson bystanders with naloxone. The dearth of research identified by this review, even in EMS settings that ...References1. Chou R, Korthuis PT, McCarty D, Coffin PO, Griffin JC, Davis-O'Reilly C, et al. Management of suspected opioid overdose with naloxone in out-of-hospital settings. A systematic review. Ann Intern Med. 2017;167:867-75. doi:10.7326/M17-2224 LinkGoogle Scholar2. National Association of State EMS Officials. National model EMS clinical guidelines. Version 11-14. 2014. Accessed at www.nasemso.org/Projects/ModelEMSClinicalGuidelines/documents/National-Model-EMS-Clinical-Guidelines-23Oct2014.pdf on 6 November 2017. Google Scholar3. National Association of State EMS Officials. National model EMS clinical guidelines. Version 2.0. 2017. Accessed at www.nasemso.org/documents/National-Model-EMS-Clinical-Guidelines-Version2-Sept2017.pdf on 6 November 2017. Google Scholar4. U.S. Office of the Press Secretary. President Donald J. Trump is Taking Action on Drug Addiction and the Opioid Crisis. Washington, DC: The White House; 2017. Accessed at www.whitehouse.gov/the-press-office/2017/10/26/president-donald-j-trump-taking-action-drug-addiction-and-opioid-crisis on 4 November 2017. Google Scholar5. Busch SH, Fiellin DA, Chawarski MC, Owens PH, Pantalon MV, Hawk K, et al. Cost-effectiveness of emergency department-initiated treatment for opioid dependence. Addiction. 2017;112:2002-2010. [PMID: 28815789] doi:10.1111/add.13900 CrossrefMedlineGoogle Scholar6. D'Onofrio G, O'Connor PG, Pantalon MV, Chawarski MC, Busch SH, Owens PH, et al. Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial. JAMA. 2015;313:1636-44. [PMID: 25919527] doi:10.1001/jama.2015.3474 CrossrefMedlineGoogle Scholar7. Davis CS, Southwell JK, Niehaus VR, Walley AY, Dailey MW. Emergency medical services naloxone access: a national systematic legal review. Acad Emerg Med. 2014;21:1173-7. [PMID: 25308142] doi:10.1111/acem.12485 CrossrefMedlineGoogle Scholar8. Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, et al. Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132:S315-67. [PMID: 26472989] doi:10.1161/CIR.0000000000000252 CrossrefMedlineGoogle Scholar9. Edwards ET, Edwards ES, Davis E, Mulcare M, Wiklund M, Kelley G. Comparative usability study of a novel auto-injector and an intranasal system for naloxone delivery. Pain Ther. 2015;4:89-105. [PMID: 25910473] doi:10.1007/s40122-015-0035-9 CrossrefMedlineGoogle Scholar10. U.S. Food and Drug Administration. Summary Review for Regulatory Action: Narcan (Naloxone Hydrochloride) Nasal Spray. Silver Spring, MD: U.S. Food and Drug Administration; 2015. Accessed at www.fda.gov/downloads/drugs/developmentapprovalprocess/developmentresources/ucm480092.pdf on 5 November 2017. Google Scholar Author, Article, and Disclosure InformationAffiliations: VA Program Evaluation and Resource Center, Office of Mental Health and Suicide Prevention, VA Center for Innovation to Implementation, Menlo Park, California (E.M.O.)VHA Pharmacy Benefits Management Services, Academic Detailing Service, Seattle, Washington (M.B.)Disclaimer: The views expressed in this article are the authors' and do not necessarily represent those of the U.S. Department of Veterans Affairs.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2963.Corresponding Author: Elizabeth M. Oliva, PhD, VA Program Evaluation and Resource Center, 795 Willow Road (152 MPD), Menlo Park, CA 94025.Current Author Addresses: Dr. Oliva: VA Program Evaluation and Resource Center, 795 Willow Road (152 MPD), Menlo Park, CA 94025.Dr. Bounthavong: Pharmacy Benefits Management, Academic Detailing Service, Veterans Health Administration, Seattle, WA 98119.This article was published at Annals.org on 28 November 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Suspected Opioid Overdose With Naloxone in Out-of-Hospital Settings Roger Chou , P. Todd Korthuis , Dennis McCarty , Phillip O. Coffin , Jessica C. Griffin , Cynthia Davis-O'Reilly , Sara Grusing , and Mohamud Daya Metrics Cited byA review of performance assessment tools for rescuer response in opioid overdose simulations and training programs 19 December 2017Volume 167, Issue 12Page: 890-891KeywordsConsciousnessElectronic medical recordsEmergency medical servicesEmergency medical techniciansForecastingHealth care facilitiesOpioidsRespirationSystematic reviewsVeteran care ePublished: 28 November 2017 Issue Published: 19 December 2017 PDF downloadLoading ...