Journal article
Risk of Delayed Intubation After Presumed Opioid Overdose in the Emergency Department
Annals of emergency medicine, Vol.85(6), pp.498-504
06/01/2025
DOI: 10.1016/j.annemergmed.2025.01.022
PMCID: PMC12955731
PMID: 40047773
Abstract
Study objective: The objective of this study was to evaluate the optimal duration of monitoring for patients with presumed opioid overdoses prior to a non-ICU admission, particularly in the context of the increasing prevalence of fentanyl analogs and other potent synthetic opioids. Given the critical role of emergency physicians in managing this public health crisis, the study aims to inform clinical decisionmaking regarding patient disposition after the initial overdose treatment. Methods: The Fentalog Study, conducted through the American College of Medical Toxicology's Toxicology Investigators Consortium, is a prospective, multi-institutional project designed to identify patients presenting to the emergency department with acute opioid overdose, gather clinical details, and confirm substances through biologic testing. This study is a secondary analysis of the Fentalog Study that assessed the risk of "delayed intubation," defined as any intubation occurring after 4 hours of arrival to the emergency department. Results: Of the 1,591 patients included, only 9 (0.6%) required delayed intubation. Eight of these patients had nonrespiratoryrelated conditions contributing to the need for intubation. One patient only had respiratory-related conditions, had respiratory acidosis, and received a total of 6.4 mg naloxone before intubation. Conclusion: This study provides evidence that delayed intubation after 4 hours of monitoring in patients with presumed opioid overdose is exceedingly rare. [Ann Emerg Med. 2025;85:498-504.]
Details
- Title: Subtitle
- Risk of Delayed Intubation After Presumed Opioid Overdose in the Emergency Department
- Creators
- Daniel J. McCabe - University of IowaHeath Gibbs - University of IowaAlessandra A. Pratt - Iowa City VA Health Care SystemRachel Culbreth - American College of Medical ToxicologyAmanda M. Sutphin - American College of Medical ToxicologyStephanie Abston - American College of Medical ToxicologyShao Li - American College of Medical ToxicologyPaul Wax - American College of Medical ToxicologyJeffrey Brent - University of Colorado DenverSharan Campleman - Baylor University Medical CenterKim Aldy - American College of Medical ToxicologyAlyssa Falise - American College of Medical ToxicologyAlex F. Manini - Elmhurst Hospital CenterToxIC Fentalog Study Group
- Resource Type
- Journal article
- Publication Details
- Annals of emergency medicine, Vol.85(6), pp.498-504
- DOI
- 10.1016/j.annemergmed.2025.01.022
- PMID
- 40047773
- PMCID
- PMC12955731
- NLM abbreviation
- Ann Emerg Med
- ISSN
- 0196-0644
- eISSN
- 1097-6760
- Publisher
- Elsevier
- Number of pages
- 7
- Grant note
- R01DA048009 / National Institute on Drug Abuse of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Drug Abuse (NIDA)
- Language
- English
- Date published
- 06/01/2025
- Academic Unit
- Emergency Medicine; Pharmacy Practice and Science; Internal Medicine
- Record Identifier
- 9984832090602771
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