Study Examines Patient Monitoring After Naloxone Administration

New research suggests the validity of a practice in which patients rescued from an opioid overdose with naloxone and stabilized are medically monitored for an hour after receiving the overdose reversal drug.

St. Paul's Hospital in Vancouver established the St. Paul's Early Discharge Rule in 2000. Researchers at the University at Buffalo sought to give external validation to the rule in light of the changing patterns of the opioid crisis.

The study, conducted at the Erie County Medical Center in Buffalo, involved 538 patients who had been transported to the hospital by ambulance after receiving naloxone. They were evaluated within 30 to 40 minutes of arrival, and had measurements of vital signs one hour after having received naloxone.

The researchers tracked patients through their hospitalization for any adverse events, and reported that most events in patients who had been monitored for a typical duration were minor and unlikely to be life-threatening.

In today's medical practice, “Recommendations for patient observation after naloxone administration are inconsistent,” said Brian Clemency, the study's lead author and associate professor of emergency medicine at the university's Jacobs School of Medicine and Biomedical Sciences. “Patients can be observed for six or more hours or they can be immediately discharged with no further evaluation.”

Study results were published last month in the journal Academic Emergency Medicine. The researchers believe the study should lead to the establishment of nationally standardized recommendations for the observation of patients after naloxone administration.