Adult Opioid-Associated Emergency Algorithm for Healthcare Providers
Algorithm at a Glance
- The provider must be able to identify when an individual may be a victim of an opioid overdose.
- In cardiac arrest, begin high-quality CPR while waiting for a defibrillator/AED and naloxone.
- Administer naloxone as soon as it is available and every 4 minutes as needed.
- Continue CPR and monitor continuously.
Goals for the Management of Opioid Overdose in Adult Patients
The responder will be able to:
- Recognize an opioid-associated life-threatening emergency
- Provide appropriate treatment for an opioid-associated emergency
Adult Opioid Algorithm Explained
This algorithm was created to present the steps for assessing and managing patients presenting with symptoms of an opioid overdose.
Opioid overdose can lead to respiratory failure and cardiac arrest.
Box 1: The Patient is Assessed and EMS Activated
If outside of the hospital, the responder calls for help and sends someone for an AED and naloxone. The responder observes the patient’s respiratory status.
Box 2: Is the Patient Breathing Normally?
If the patient is breathing normally, the rescuer proceeds to Box 3. If the patient is NOT breathing normally (gasping or no breathing), they proceed to Box 5.
Related Video – Understanding Agonal Breathing
Box 3: Supporting the Patient
The responder maintains an open airway and prepares for transport to the emergency department. Naloxone administration should be considered if available.
Box 4: Continuous Monitoring
The rescuer continues to assess the patient’s breathing and level of consciousness until EMS arrives for transport.
Box 5: Does the Patient Have a Pulse?
If the patient is not breathing, the rescuer checks for a pulse in < 10 seconds. If there is a pulse, they proceed to Box 6. If no pulse is felt, they proceed to Box 7.
Box 6: Supporting the Patient
The responder maintains an open airway and provides rescue breathing as needed. Naloxone should be administered as soon as possible and the patient prepared for transport to the ED.
Naloxone, an opioid antagonist, treats opioid overdose.
Box 7: High-Quality CPR
If only one rescuer is available, the rescuer performs high-quality CPR for 2 minutes before calling for help and retrieving an AED and naloxone. The rescuer considers the administration of naloxone if available. The responder follows the Cardiac Arrest algorithm and uses the AED or defibrillator when available.
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