Hi everyone. This is Steve Carroll and this is the In Basic Podcast. Today's episode is

Part 2 on opioid overdose by Dr. Shana Gifford. In this episode, she's going to talk about

a differential diagnosis for those altered patients in case they don't respond to naloxone,

some special situations such as methadone overdoses, how to properly disposition these patients,

how to briefly screen for opioid abuse in the ED, and how to be prescribed responsibly.

After the episode, I'll come back on to emphasize a few points. One thing to clarify,

towards the end of the episode, Dr. Gifford talks about limiting opioids to 60 milligrams of morphine,

no more than twice a day. That's in reference to morphine equivalence, which I'll talk a little

more about at the end of the podcast. With that said, let's get started with Dr. Shana Gifford

on opioid overdose management and treatment, Part 2. Welcome back to part two of prescription opioid overdoses on the M-BASIC.

In part one, we went over the problem that we currently have going on in this country with the opioid epidemic.

We talked about a prototypical patient who ODs and a presentation.

We went over the routes of administration and dosing

of Narcan for either the code or the nice wake-up. Using this information, by the time we finish

the initial assessment and stabilization of our 47-year-old female patient that we started running

through in part one, we'll know a lot more about opioids and the general workup of a patient like this.

So let's go back to our patient.

When last we saw her, she was on an arcaneb at two milligrams per milliliter.

Her vitals, by the way, in the department when she first came in, just a quick review.

Her heart rate was 57, respiratory rate 7, BP 10 first came in, just a quick review. Her heart was 57,

respiratory rate 7, BP 109 over 70, GCS of 8. With the administration of the 2 milligrams

by Neb and the ED, her vital signs improved. She's satting now over 94. She's in a regular

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