Establishment of a pharmacist-led service for patients at high risk for opioid overdose.

Purpose: A program at a family medicine clinic to provide naloxone prescriptions in conjunction with education on naloxone use and opioid hazards to patients at risk for opioid overdose is described.

Summary: Consistent with a 2016 Centers for Disease Control and Prevention (CDC) guideline on opioid prescribing for chronic pain, a family medicine clinic implemented updated controlled substance agreements and medical record templates for documentation of pain management visits and established a pharmacist-led naloxone clinic. Chart reviews were performed to identify patients eligible for naloxone, as defined by the CDC guideline.

Use of telehealth for patients referred to a retrieval service: timing, destination, mode of transport, escort level and patient care.

We examined the utility of telehealth in assisting the decision-making processes of aeromedical coordinators, with particular focus on the timing, destination, mode of transport and escort level. Medical coordinators from the Northern Operations site of the Queensland emergency retrieval service were asked to complete a survey form about the changes that telehealth made to their retrieval decision-making process. Information was collected in six areas: diagnosis, severity, priority, crew, mode of transport and destination.

Agreement between bicarbonate measured on arterial and venous blood gases.

Objective: This study aims to determine the extent of agreement between venous and arterial bicarbonate for a group of emergency department patients with respiratory or metabolic illness requiring blood gas analysis as part of their evaluation.

Methods: This prospective study of patients who were deemed by their treating doctor to require an arterial blood gas analysis to determine their ventilatory or acid-base status, compared bicarbonate on an arterial and a venous sample taken as close to simultaneously as possible. Data were analysed using bias (Bland-Altman) methods.

Venous pCO(2) and pH can be used to screen for significant hypercarbia in emergency patients with acute respiratory disease.

This prospective study of patients with acute respiratory illness or potential ventilatory compromise compared pCO(2) and pH on an arterial and a venous blood sample with the aims of determining whether venous pH and pCO(2) can replace arterial values in the management of patients with acute respiratory disease and to determine whether there is a cut-off level of venous pCO(2) that can accurately screen for significant hypercarbia (pCO(2) > 50 mm Hg). Data were analyzed using bias plot and receiver operator characteristic (ROC) curve methods. There were 196 sample-pairs analyzed; 56 (29%) had significant hypercarbia.