Pediatric Opioid Overdose Algorithm for Healthcare Providers (HCP)
Algorithm at a Glance
- The provider identifies a child with a possible opioid overdose.
- High-quality CPR begins immediately when the child is in cardiac arrest while the provider waits for a defibrillator/AED and naloxone.
- Naloxone administration occurs as soon as it is available and every 4 minutes as needed.
- CPR and monitoring are continuous.
Goals for the Management of Pediatric Patients With Opioid Overdose
The provider will be able to:
- Recognize an opioid-associated life-threatening emergency.
- Provide appropriate treatment for an opioid-associated emergency.
Pediatric Opioid Algorithm for HCP Explained
This algorithm outlines the steps for assessing and managing children presenting with symptoms of an opioid overdose.
Morphine is an opioid.
Box 1: Assess and Activate
The provider assesses the child for responsiveness and calls for help. If there is a bystander, the provider sends that person to retrieve an AED and naloxone.
Box 2: Normal Breathing?
The provider determines if the child is breathing normally. If yes, the provider proceeds to Box 3; if no, the provider proceeds to Box 5.
Related Video – Understanding Agonal Breathing
Box 3: Support the Child
The provider positions the child for comfort and to maintain a patent airway. When naloxone is available, the provider considers the administration of the medication.
Naloxone is administered to reverse an opioid overdose.
Box 4: Continue Assessment
As the provider waits for help, they constantly return to boxes 1 and 2 to re-evaluate the child.
Box 5: Pulse Within 10 Seconds?
If breathing is not normal, the provider feels for a pulse for no longer than 10 seconds. If a pulse is felt, the provider proceeds to Box 6.
If a pulse is not felt, the provider proceeds to Box 7.
Box 6: Support the Child
When a pulse is felt, the provider positions the child for comfort and maintains a patent airway. When naloxone is available, the medication is administered. In the case of an out-of-hospital arrest, the child is transferred to the hospital as soon as possible.
Box 7: Begin CPR
When the child’s pulse is not felt, the provider immediately begins using the BLS Cardiac Arrest algorithm. The AED is used, and naloxone is administered as soon as available.
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