The following is a summary of “Outcomes of out-of-hospital cardiac arrest patients who received naloxone in an emergency medical services system with a high prevalence of opioid overdose,” published in the September 2024 issue of Emergency Medicine by Quinn et al.
Opioid-associated out-of-hospital cardiac arrest (OA-OHCA) represents a type of cardiac arrest that may be improved by interventions beyond standard Advanced Cardiac Life Support (ACLS), including the use of naloxone.
Researchers conducted a retrospective study to investigate whether patients with OHCA chosen for naloxone therapy by emergency medical services (EMS) clinicians in a region with high opioid overdose rates would have inflated rates of return of spontaneous circulation (ROSC) and survival to hospital discharge.
They performed an analysis in an urban EMS system with a high prevalence of opioid overdose while paramedics could administer naloxone in cardiac arrest in addition to ACLS. Naloxone was often aided based on clinical gestalt for suspected OA-OHCA. In comparing the outcomes of patients with OHCA who received naloxone against those who received usual care, both adjusted and unadjusted, a Logistic regression model was used to test for an independent association of naloxone administration on ROSC and survival to hospital discharge.
The results showed that 769 patients with OHCA were analyzed, with 175 individuals (23%) having naloxone, while on average, patients who received naloxone had fewer comorbidities and were younger. No similarities in ROSC, survival to hospital discharge, or modified Rankin scores, and logistic regression modeling revealed no statistical effect of naloxone administration on outcomes.
They concluded that patients with OHCA who received naloxone, being younger and having fewer comorbidities, had similar results to those with usual care.
Source: sciencedirect.com/science/article/abs/pii/S0736467924001148
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