Comparison of Correlation between Naloxone Administered by Emergency Medical Services and Hospital Poisoning Emergency Service in Patients with Opioid Poisoning

Background: Emergency Medical Service (EMS) has an important role in the management of patients with opioid poisoning. Proper administration of naloxone is life-saving in these patients. We performed a study to compare the correlation between naloxone prescribed by the EMS and poisoning emergency physician in hospital for patients with opioid poisoning.
Methods: Patients with opioid poisoning referred by EMS to the poisoning emergency room of Khorshid Hospital affiliated to Isfahan University of Medical Sciences, Iran, from April 2016 to March 2017 were evaluated for toxico-epidemiological factors and outcome.
Findings: Out of 340 patients studied, 80% were men. Poisoning with methadone (33.3%) and opium (23.2%) were the most opioid poisoning. 47.9% of patients were drowsy after administration of naloxone by EMS, 35.9% were fully conscious, and 3.5% were restless. There was a significant difference in blood oxygen saturation between the two groups receiving and not receiving naloxone by EMS (P = 0.02). The mean age of patients receiving naloxone by EMS and hospital emergency service was higher than patients not receiving naloxone. There was a strong correlation between naloxone administration by EMS and in the hospital (r = 0.77; P < 0.001). Kind of opioid (opium) and patient’s age (more than 40 years) predicted the naloxone administration by EMS and in the hospital. All patients recovered completely.
Conclusion: There was a strong correlation in naloxone administration between EMS and emergency service in hospital. Due to the high average age of patients receiving naloxone, more attention to prevent possible side effects of naloxone is recommended.