Evidence map›Paper›PMID 35670914›Full record

ArticleCJEM2022

Out-of-hospital management of unresponsive, apneic, witnessed opioid overdoses: a case series from a supervised consumption site.

Adrianna Rowe, Andrew Chang, Emily Lostchuck, Kathleen Lin, Frank Scheuermeyer, Victoria McCann, Jane Buxton, Jessica Moe, Raymond Cho, Paul Clerc and 3 more

Abstract read
PubMed Publisher
In one paragraph

Article in CJEM, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 13 citations in OpenAlex.

  1. Review
  2. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023
    Article
  3. Observational
  4. Guidance on take-home naloxone distribution and use by community overdose responders in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 1 country.

Adrianna RoweDepartment of Emergency Medicine, University Health Network, ON, Toronto, Canada. arowe.md@gmail.com.ORCID 0000-0002-5396-9363
Andrew ChangDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Emily LostchuckDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Kathleen LinFaculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Frank ScheuermeyerDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Victoria McCannFaculty of Medicine, Queen's University, Kingston, ON, Canada.
Jane BuxtonBritish Columbia Centre for Disease Control, Vancouver, BC, Canada.
Jessica MoeDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Raymond ChoDepartment of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
Paul ClercDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Connor McSweeneyFaculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Andy JiangDepartment of Internal Medicine, University of Western Ontario, London, ON, Canada.
Roy PurssellDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
University of British Columbia · CAQueen's University · CAUniversity Health Network · CAUniversity of Toronto · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThere are conflicting recommendations for lay rescuer management of patients who are unresponsive and apneic due to opioid overdose. We evaluated the management of such patients at an urban supervised consumption site.

methodsAt a single urban supervised consumption site in Vancouver, BC, we conducted a retrospective chart review and administrative database linkage of consecutive patients who were unresponsive and apneic following witnessed opioid overdose between January 1, 2012 and December 31, 2017. We linked these visits with regional hospital records to define the entire care episode, which concluded when the patient was discharged from the supervised consumption site, ED, or hospital, or died. The primary outcome was successful resuscitation, defined as alive and neurologically intact (ambulatory and speaking coherently, or alert and oriented, or Glasgow Coma Scale 15) at the conclusion of the care episode. Secondary outcomes included mortality and predefined complications of resuscitation.

resultsWe collected 767 patients, with a median age of 43 and 81.6% male, with complete follow-up on 763 patients (99.5%). All patients were managed with oxygen and ventilation (100%, 95% CI 0.995-1.0); 715 (93.2%, 95% CI 0.911-0.949) received naloxone; no patients underwent chest compressions (0%, 95% CI 0-0.005). All patients with complete follow-up were alive and neurologically intact at the end of their care episode (100%, 95% CI 0.994-1.0). Overall, 191 (24.9%) patients were transported to hospital, and 15 (2.0%) patients required additional naloxone after leaving the supervised consumption site; 16 (2.1%) developed complications, and 1 patient was admitted to hospital.

conclusionsAt an urban supervised consumption site, all unresponsive, apneic patients with witnessed opioid overdose were successfully resuscitated with oxygen and/or naloxone. No patients required chest compressions.

Indexed as

Drug OverdoseOpiate OverdoseAnalgesics, OpioidFemaleHospitalsHumansMaleNaloxoneOxygenRetrospective StudiesAnalgesics, OpioidNaloxoneOxygenCardiopulmonary resuscitationHarm reductionOpiate overdoseVentilation

Identifiers

PMID35670914
OpenAlexW4281754262

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.