https://ogma.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:50169 15 years) patients treated by an Australian state ambulance service with 1.6 mg IM administration of naloxone for respiratory depression (respiratory rate <11 breaths/min and/or oxygen saturation <93% in room air) caused by presumed opioid poisoning. The primary outcome was the proportion of presentations with severe agitation (Sedation Assessment Tool score >1) within 1 hour of naloxone administration. Secondary outcomes were the proportion of presentations with acute opioid withdrawal (tachycardia [pulse rate >100 beats/min], hypertension [systolic >140 mm Hg], vomiting, agitation, seizure, myocardial infarction, arrhythmia, or pulmonary edema), and reversal of respiratory depression (respiratory rate >10 breaths/min and saturation >92% or Glasgow Coma Scale score 15). Results: From October 2019 to July 2021, there were 197 presentations in 171 patients, with a median age of 41 years (range, 18 to 80 years); of the total patients, 119 were men (70%). The most common opioids were heroin (131 [66%]), oxycodone (14 [7%]), and morphine (11 [6%]). Severe agitation occurred in 14 (7% [95% confidence interval {CI} 4% to 12%]) presentations. Opioid withdrawal occurred in 76 presentations (39% [95% CI 32% to 46%]), most commonly in the form of tachycardia (18%), mild agitation/anxiety (18%) and hypertension (14%). Three presentations (1.5%) received chemical sedation for severe agitation within 1 hour of naloxone administration. A single 1.6 mg dose of naloxone reversed respiratory depression in 192 (97% [95% CI: 94% to 99%]) presentations. Conclusion: Severe agitation was uncommon following the administration of 1.6 mg IM naloxone and rarely required chemical sedation.]]> Wed 05 Jul 2023 16:31:40 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:8129 Sat 24 Mar 2018 08:40:04 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:14880 Sat 24 Mar 2018 08:22:23 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:14357 Sat 24 Mar 2018 08:20:13 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:10822 Sat 24 Mar 2018 08:13:37 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:11519 Sat 24 Mar 2018 08:10:23 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:19026 7 years) with a redback spider bite and severe pain, with or without systemic effects, were randomized to receive normal saline solution (placebo) or antivenom after receiving standardized analgesia. The primary outcome was a clinically significant reduction in pain 2 hours after trial medication compared with baseline. A second primary outcome for the subgroup with systemic features of envenomation was resolution of systemic features at 2 hours. Secondary outcomes were improved pain at 4 and 24 hours, resolution of systemic features at 4 hours, administration of opioid analgesics or unblinded antivenom after 2 hours, and adverse reactions. Results: Two hours after treatment, 26 of 112 patients (23%) from the placebo arm had a clinically significant improvement in pain versus 38 of 112 (34%) from the antivenom arm (difference in favor of antivenom 10.7%; 95% confidence interval −1.1% to 22.6%; P=.10). Systemic effects resolved after 2 hours in 9 of 41 patients (22%) in the placebo arm and 9 of 35 (26%) in the antivenom arm (difference 3.8%; 95% confidence interval −15% to 23%; P=.79). There was no significant difference in any secondary outcome between antivenom and placebo. Acute systemic hypersensitivity reactions occurred in 4 of 112 patients (3.6%) receiving antivenom. Conclusion: The addition of antivenom to standardized analgesia in patients with latrodectism did not significantly improve pain or systemic effects.]]> Sat 24 Mar 2018 08:05:28 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:5173 Sat 24 Mar 2018 07:47:42 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:298 Sat 24 Mar 2018 07:43:42 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:28152 Sat 24 Mar 2018 07:36:34 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:28153 Sat 24 Mar 2018 07:36:34 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:27225 Sat 24 Mar 2018 07:32:25 AEDT ]]>