II. Findings: Signs and Symptoms
- Apnea
- Bradycardia
- Coma
- Hypertension or Hypotension
- Hypothermia
- Mental status change
- Pinpoint pupils (Miosis)
- Respiratory Depression
III. Management: Adults
- ABC Management
-
Naloxone
- Indicated in respiratory depression and apnea or significant CNS depression
- Initial
- No respiratory depression: 0.1 to 0.4 mg IV or IM
- Respiratory depression: 1 to 2 mg IV or IM
- Next, if no response or incomplete response
- Give 2 mg IV or IM every 3-5 minutes to a total of 10 mg total maximum
- Redosing may be needed due to short naloxone Half-Life
-
Atropine
- Indicated in severe Sinus Bradycardia
- Atropine 0.5 to 1 mg IV (may repeat after 3 to 5 min, up to a maximum total dose of 3 mg)
-
Vasopressors
- Indicated for Hypotension refractory to Intravenous Fluids
- Norepinephrine or Epinephrine IV
IV. Management: Children
- ABC Management
-
Naloxone
- Initial
- No respiratory depression: 0.1 mg/kg to 0.4 mg IV or IM
- Respiratory depression: 1 to 2 mg IV or IM
- Next, if no response or incomplete response
- Give 2 mg IV or IM every 3-5 minutes to a total of 10-20 mg
- Initial
-
Atropine
- Indicated in Severe Bradycardia
- Start: Atropine 0.02 mg/kg up to 0.16 mg IV
- Maximum: Atropine 0.5 mg/kg IV
-
Vasopressors
- Indicated for Hypotension refractory to Intravenous Fluids
- Norepinephrine or Epinephrine IV