TY - JOUR
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - CCF cross-correlation coefficient
KW - Child
KW - Child, Preschool
KW - Drug overdose
KW - Drug Overdose/therapy
KW - ED emergency department
KW - Emergency Medical Services
KW - EMR electronic medical record
KW - EMS Emergency Medical Services
KW - Female
KW - Heroin Dependence/therapy
KW - Humans
KW - IV intravenous
KW - Male
KW - Middle Aged
KW - naloxone
KW - Naloxone/administration & dosage
KW - Narcotic Antagonists/administration & dosage
KW - OD overdose
KW - Opioid
KW - Opioid-Related Disorders/therapy
KW - Public Health Surveillance/methods
KW - Retrospective Studies
KW - surveillance
KW - Young Adult
AU - H. A. Lindstrom
AU - B. M. Clemency
AU - R. Snyder
AU - J. D. Consiglio
AU - P. R. May
AU - R. M. Moscati
A1 - 
AB - BACKGROUND: Abuse or unintended overdose (OD) of opiates and heroin may result in prehospital and emergency department (ED) care. Prehospital naloxone use has been suggested as a surrogate marker of community opiate ODs. The study objective was to verify externally whether prehospital naloxone use is a surrogate marker of community opiate ODs by comparing Emergency Medical Services (EMS) naloxone administration records to an independent database of ED visits for opiate and heroin ODs in the same community. METHODS: A retrospective chart review of prehospital and ED data from July 2009 through June 2013 was conducted. Prehospital naloxone administration data obtained from the electronic medical records (EMRs) of a large private EMS provider serving a metropolitan area were considered a surrogate marker for suspected opiate OD. Comparison data were obtained from the regional trauma/psychiatric ED that receives the majority of the OD patients. The ED maintains a de-identified database of narcotic-related visits for surveillance of narcotic use in the metropolitan area. The ED database was queried for ODs associated with opiates or heroin. Cross-correlation analysis was used to test if prehospital naloxone administration was independent of ED visits for opiate/heroin ODs. RESULTS: Naloxone was administered during 1,812 prehospital patient encounters, and 1,294 ED visits for opiate/heroin ODs were identified. The distribution of patients in the prehospital and ED datasets did not differ by gender, but it did differ by race and age. The frequency of naloxone administration by prehospital providers varied directly with the frequency of ED visits for opiate/heroin ODs. A monthly increase of two ED visits for opiate-related ODs was associated with an increase in one prehospital naloxone administration (cross-correlation coefficient [CCF]=0.44; P=.0021). A monthly increase of 100 ED visits for heroin-related ODs was associated with an increase in 94 prehospital naloxone administrations (CCF=0.46; P=.0012). CONCLUSIONS: Frequency of naloxone administration by EMS providers in the prehospital setting varied directly with frequency of opiate/heroin OD-related ED visits. The data correlated both for short-term frequency and longer term trends of use. However, there was a marked difference in demographic data suggesting neither data source alone should be relied upon to determine which populations are at risk within the community.
BT - Prehospital and Disaster Medicine
C5 - Opioids & Substance Use; HIT & Telehealth
CP - 4
CY - United States
DO - 10.1017/S1049023X15004793
IS - 4
JF - Prehospital and Disaster Medicine
N2 - BACKGROUND: Abuse or unintended overdose (OD) of opiates and heroin may result in prehospital and emergency department (ED) care. Prehospital naloxone use has been suggested as a surrogate marker of community opiate ODs. The study objective was to verify externally whether prehospital naloxone use is a surrogate marker of community opiate ODs by comparing Emergency Medical Services (EMS) naloxone administration records to an independent database of ED visits for opiate and heroin ODs in the same community. METHODS: A retrospective chart review of prehospital and ED data from July 2009 through June 2013 was conducted. Prehospital naloxone administration data obtained from the electronic medical records (EMRs) of a large private EMS provider serving a metropolitan area were considered a surrogate marker for suspected opiate OD. Comparison data were obtained from the regional trauma/psychiatric ED that receives the majority of the OD patients. The ED maintains a de-identified database of narcotic-related visits for surveillance of narcotic use in the metropolitan area. The ED database was queried for ODs associated with opiates or heroin. Cross-correlation analysis was used to test if prehospital naloxone administration was independent of ED visits for opiate/heroin ODs. RESULTS: Naloxone was administered during 1,812 prehospital patient encounters, and 1,294 ED visits for opiate/heroin ODs were identified. The distribution of patients in the prehospital and ED datasets did not differ by gender, but it did differ by race and age. The frequency of naloxone administration by prehospital providers varied directly with the frequency of ED visits for opiate/heroin ODs. A monthly increase of two ED visits for opiate-related ODs was associated with an increase in one prehospital naloxone administration (cross-correlation coefficient [CCF]=0.44; P=.0021). A monthly increase of 100 ED visits for heroin-related ODs was associated with an increase in 94 prehospital naloxone administrations (CCF=0.46; P=.0012). CONCLUSIONS: Frequency of naloxone administration by EMS providers in the prehospital setting varied directly with frequency of opiate/heroin OD-related ED visits. The data correlated both for short-term frequency and longer term trends of use. However, there was a marked difference in demographic data suggesting neither data source alone should be relied upon to determine which populations are at risk within the community.
PP - United States
PY - 2015
SN - 1049-023X; 1049-023X
SP - 385
EP - 389
EP - 
T1 - Prehospital Naloxone Administration as a Public Health Surveillance Tool: A Retrospective Validation Study
T2 - Prehospital and Disaster Medicine
TI - Prehospital Naloxone Administration as a Public Health Surveillance Tool: A Retrospective Validation Study
U1 - Opioids & Substance Use; HIT & Telehealth
U2 - 26061280
U3 - 10.1017/S1049023X15004793
VL - 30
VO - 1049-023X; 1049-023X
Y1 - 2015
ER -