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Table 5 Interventions commonly delivered following opioid-related overdoses in the ambulance, tertiary hospital ED and upon discharge

From: Retrospective analysis of patterns of opioid overdose and interventions delivered at a tertiary hospital emergency department: impact of COVID-19

Interventions Delivered

March-to-August

N (%)

2019

2020

Total

Ambulance Interventions

N = 37

N = 18

N = 55

  Oxygen

13 (35.1)

4 (22.2)

17 (30.9)

  Oropharyngeal airway insertion

10 (27.0)

2 (11.1)

12 (21.8)

  IV/IM naloxone

9 (24.3)

0 (0)

9 (16.4)

  Declined IV/IM naloxone

0 (0)

1 (5.6)

1 (1.8)

ED Interventions

N = 42

N = 26

N = 68

  IV/IM naloxone

8 (19.0)

14 (53.8)

22 (32.4)

  Psychiatric review

12 (28.6)

6 (23.1)

18 (26.5)

  Declined psychiatric review

3 (7.1)

0 (0)

3 (4.4)

  Paracetamol

9 (21.4)

6 (23.1)

15 (22.1)

  Drug and alcohol assessment

6 (14.3)

8 (30.8)

14 (20.6)

  Declined drug and alcohol assessment

2 (4.8)

2 (7.7)

4 (5.9)

  Oral/IV benzodiazepines (diazepam, midazolam, lorazepam and/or temazepam)

10 (23.8)

4 (15.4)

14 (20.6)

  Social work team review

7 (16.7)

3 (11.5)

10 (14.7)

  Declined social work team review

1 (2.4)

1 (3.8)

2 (2.9)

  Intubation and ventilation

6 (14.3)

3 (11.5)

9 (13.2)

  Naloxone infusion

2 (4.8)

5 (19.2)

7 (10.3)

  Self-harm and crisis counselling services team review

3 (7.1)

2 (7.7)

5 (7.4)

  N-acetylcysteine infusion

2 (4.8)

3 (11.5)

5 (7.4)

Post-discharge Interventions

N = 35

N = 24

N = 59a

  General practitioner follow-up

15 (42.9)

8 (33.3)

23 (39.0)

  Psychology

10 (28.6)

3 (12.5)

13 (22.0)

  Indirect referral or continued engagement with community, non-government organisation or private drug and alcohol services

5 (14.3)

7 (29.2)

12 (20.3)

  Declined drug and alcohol services engagement

2 (5.7)

2 (8.3)

4 (6.8)

  Psychiatrist follow-up or transfer/referral to psychiatric hospital

6 (17.1)

5 (20.8)

11 (18.6)

  Changes to opioid and/or psychotropic medications (ceased, reduced dose and/or modified patient access)

5 (14.3)

2 (8.3)

7 (11.9)

  Self-help and crisis counselling services information and/or follow-up

4 (11.4)

2 (8.3)

6 (10.2)

  Harm minimisation education, including education regarding risks of overdose

4 (11.4)

1 (4.2)

5 (8.5)

  Mental health crisis information and contact numbers (e.g., Mental Health Emergency Response Line number)

4 (11.4)

1 (4.2)

5 (8.5)

  Mental health care plan (to be provided by general practitioner)

4 (11.4)

0 (0)

4 (6.8)

  Family involvement (e.g., psychoeducation or facilitation of discharge management plan)

1 (2.9)

3 (12.5)

4 (6.8)

  1. ED emergency department, IV intravenous, IM intramuscular, NSAID non-steroidal anti-inflammatory drug
  2. aNine patients were admitted as inpatients and not discharged from the ED