{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T10:24:41Z","timestamp":1749723881240,"version":"3.40.5"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T00:00:00Z","timestamp":1660521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Opioid overdose is increasing and accounts for two\u2010thirds of poisoning deaths. Opioid induced respiratory depression is life\u2010threatening and can be under\u2010recognised even in the hospital setting. We aimed to evaluate the effect of a care pathway on the management of opioid\u2010poisoned patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a before\u2013after observational study following the introduction of a nursing care pathway for opioid\u2010poisoned patients presenting to ED. Medical records were retrospectively reviewed pre (6\u2010month period 1 year prior) and post (9\u2010month period following) the introduction of the pathway. The primary outcome was the proportion of documented episodes of respiratory depression (respiratory rate\u2009&lt;10 or oxygen saturation\u2009&lt;93% on room air) receiving naloxone. Secondary outcomes were time to naloxone, number of documented observations (first 4 h) and length of stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 111 patients included in the study, 61 pre\u2010intervention and 50 post\u2010intervention (35 followed the pathway). A significantly larger proportion of patients received naloxone for respiratory depression when the pathway was used (134\/200 [67%] <jats:italic>vs<\/jats:italic> 34\/118 [29%], difference 38%, 95% CI 28\u201348%). The median time to naloxone was similar (pathway 28.5\u00a0min <jats:italic>vs<\/jats:italic> no pathway 35 min, difference \u22126.5\u00a0min, 95% CI \u221219 to 12\u2009min). Documentation increased when the pathway was used (12.0 observations\/presentation <jats:italic>vs<\/jats:italic> 7.5 observations\/presentation, difference 4.5 observations\/patient, 95% CI 2.1\u20137.0 observations\/patient). Length of stay was similar (pathway 16.7\u00a0h <jats:italic>vs<\/jats:italic> no pathway 15.3\u00a0h, difference 1.4\u00a0h, 95% CI \u22122.4 to 5.9\u00a0h).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Following the introduction of a dedicated opioid poisoning nursing care pathway, naloxone delivery and observation documentation increased. A care pathway may improve ED management of opioid poisoning.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.14056","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T02:03:19Z","timestamp":1660615399000},"page":"69-73","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Dedicated nursing care pathway improved management of opioid\u2010poisoned patients in the emergency department: A before\u2013after observational study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1176-7923","authenticated-orcid":false,"given":"Katherine","family":"Isoardi","sequence":"first","affiliation":[{"name":"Clinical Toxicology Unit and Emergency Department Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"Clinical Toxicology Research Group The University of Newcastle  Newcastle New South Wales Australia"},{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Learmont","sequence":"additional","affiliation":[{"name":"Clinical Toxicology Unit and Emergency Department Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Horan","sequence":"additional","affiliation":[{"name":"Clinical Toxicology Unit and Emergency Department Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1519-7419","authenticated-orcid":false,"given":"Geoffrey","family":"Isbister","sequence":"additional","affiliation":[{"name":"Clinical Toxicology Research Group The University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"volume-title":"Estimated World Requirements for 2020, Statistics for 2018","year":"2020","author":"Narcotic Drugs","key":"e_1_2_9_2_1"},{"volume-title":"Australia's Annual Overdose Report 2020","year":"2020","author":"Penington Institute","key":"e_1_2_9_3_1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042098617744161"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-197601030-00004"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-021-01307-8"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmacy9020101"},{"key":"e_1_2_9_8_1","first-page":"87","article-title":"Clinical pathways\u2010\u2010the new paradigm in healthcare?","volume":"53","author":"Cheah TS","year":"1998","journal-title":"Med. 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