Opioid Overdose; Roadside to Resus

The Resus Room

Simon Laing

Science, Emergencymedicine, Medicine, Health & Fitness, Em, Ae

4.8 • 678 Ratings

🗓️ 15 April 2025

⏱️ 51 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Opioid toxicity is a major and growing challenge across the UK and beyond, with nearly 10 deaths every day from opioid overdose and over a million adults using Class A drugs annually, the impact on emergency services is enormous.

In this episode, we’re diving deep into the recognition and management of acute opioid toxicity in the emergency setting, including the reversal using naloxone.

We’ll run through;

The scale of the problem, including the rise of novel synthetic opioids like fentanyl and nitazenes.
A breakdown of opioid pharmacology, including receptor types, potencies, and onset of action.
How to identify classic and mixed presentations of opioid overdose.
Best practice on naloxone dosing, routes of administration, and when to start infusions.
The risk of acute withdrawal and how to manage it with care.
How to approach mixed overdoses, cardiac arrests involving opioids, and nebulised naloxone.
And finally, the importance of holistic care, safeguarding, and onward referral to support recovery.

Whether you’re in ED, prehospital care, or just want to sharpen your tox knowledge, this episode’s packed with take-home learning. Oh, and yes... Gangs of London gets a shout-out too.

Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!

Simon, Rob & James

Transcript

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0:00.0	Welcome to the Recess Room podcast.
0:03.5	Five, four, three, two, one, fire.
0:12.3	So hi and welcome back to the Reeser Room podcast.
0:15.6	I'm Simon Lang.
0:17.0	I'm Rob Fenwick, and I'm James Yates.
0:19.2	And we're back with another roadside to resus
0:22.0	And this time it's on opioid overdose
0:25.6	Yeah certainly is I'm really really looking forward to this episode
0:28.3	Although I'm going to have to listen back to it
0:29.9	Because I was at a gig last night
0:31.1	And I can't hear a thing that you boys are saying
0:33.3	So just give me a nudge when it's my go
0:35.3	You know, send me a text or something and i'll and i'll speak but
0:37.6	i'm sure it's going to be a great episode how very young and cool of you james god's a gig goodness me who
0:42.9	was it neil young or something i couldn't possibly disclose like james though i tell you i think
0:50.3	this is going to be a great episode you know we've talked about this idea of this deliberate practice before, and I think this is a really great example of it. So, you know, out there you're going to see clinicians pushing big doses in the loxone and as a sort of instinctive things. But when you see someone really consider that decision, oh, it's a wonderful thing to see. So I'm looking forward to reviewing the evidence, the guidelines, and hopefully enabling everyone to be aware of what good practice actually looks like in this
1:15.0	area, fingers crossed anyway. Yeah, I'm very happy to be back on a microphone, rather than being
1:19.2	stared at down the lens of a camera, because we had the pleasure of shooting. That makes
1:23.7	it sound really cool, isn't it? But shooting a course, didn't we earlier this week, Rob?
1:27.8	Oh, we certainly did.
1:29.0	In the glorious sunshine in Shropshire, we managed to get a load of footage for our upcoming extrication training package.
1:35.8	And, yeah, we're putting it together.
	...

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