Objectives: Buprenorphine is becoming a key component of prehospital management of opioid use disorder. It is unclear how many prehospital patients might be eligible for buprenorphine induction, as traditional induction requires that patients first have some degree of opioid withdrawal. The primary aim of this study was to quantify how many patients developed precipitated withdrawal after receiving prehospital naloxone for suspected overdose, as they could be candidates for prehospital buprenorphine.
View Article and Find Full Text PDFObjectives: The Screening, Brief Intervention, and Referral to Treatment (SBIRT) framework is a validated process that is used to identify individuals with substance use disorders (SUDs) and then encourage them to engage in and facilitate entry into treatment. It is not known how well SBIRT can be incorporated into prehospital practice and what barriers to Emergency Medical Services (EMS) implementation of an SBIRT program might arise. The aim of this project was to implement a pilot EMS based SBIRT program.
View Article and Find Full Text PDFObjectives: Hydrazine (HZ) and Hydrazine Derivative (HZ-D) exposures pose health risks to people in industrial and aerospace settings. Several recent systematic reviews and case series have highlighted common clinical presentations and management strategies. Given the low frequency at which HZ and HZ-D exposures occur, a strong evidence base on which to develop an evidence-based guideline does not exist at this time.
View Article and Find Full Text PDFObjectives: There is little understanding of the circumstances behind fatal pediatric opioid poisonings. Our objective was to characterize opioid fatalities according to child, family, and household factors.
Methods: We used data from the National Fatality Review-Case Reporting System to describe the circumstances behind the deaths of children 0 to 17 years of age who died of an opioid poisoning (ie, prescription opioid, heroin, illicit fentanyl) between 2004 and 2020.
Introduction: Historically, prehospital care of trauma patients has included nearly universal use of a cervical collar (C-collar) and long spine board (LSB). Due to recent evidence demonstrating harm in using LSBs, implementation of new spinal motion restriction (SMR) protocols in the prehospital setting should reduce LSB use, even among patients with spinal cord injury. Our goal in this study was to evaluate the rates of and reasons for LSB use in high-risk patients-those with hospital-diagnosed spinal cord injury (SCI)-after statewide implementation of SMR protocols.
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