Narcan with negative tox screen

Nurses Medications

Published

Confused about a pt on the floor...

Any reason ER would give narcan (twice - 0.4 mg then 2 mg) to a pt with a negative tox screen? Pt c/o chest pain, lethargic. CT neg for stroke, cardiac enzymes neg. Can't quite figure out why narcan was given (& it was after the results of tox screen were available).

Any ideas?

Sounds like they were just questioning overdose and wanted to see if it made a difference, sometimes a patient "appears" to respond to a first dose of narcan so they try another dose. Is it possible they gave the narcan prior to receiving the Utox results? On another note, I've seen a 5150 patient arrive in the department shortly after guzzling a bunch of pills, the initial Utox was gathered right away and came back clean but they ended up on a narcan drip.

Up Vote Up Vote ×
Specializes in Psych ICU, addictions.
Confused about a pt on the floor...

Any reason ER would give narcan (twice - 0.4 mg then 2 mg) to a pt with a negative tox screen? Pt c/o chest pain, lethargic. CT neg for stroke, cardiac enzymes neg. Can't quite figure out why narcan was given (& it was after the results of tox screen were available).

Any ideas?

Because an opiate OD was suspected even though the patient didn't pop positive for whatever reason. There's a few reasons it might be negative: the drug level was under the threshold for a positive result, the specific drug wasn't screened for, the drug was taken recently and it's too soon to show in the urine, a defective test itself, error on the part of the person conducting the test...

Up Vote Up Vote ×
Specializes in PACU, pre/postoperative, ortho.
Is it possible they gave the narcan prior to receiving the Utox results?

Not according to the documented times. First dose of narcan was about 90 minutes or so after labs & there was about another hr or so after that for the second dose. I'm guessing like what has been stated above, that it was a shot in the dark.

I was off for the next few nights after that so never really heard what the docs might have determined was the problem or what happened with the pt.

Up Vote Up Vote ×
Specializes in Critical Care.

Narcan should be used conservatively as it does have high potential for very serious complications particularly with certain comborbidities. The common recommendation is that it should only be titrated to achieve a minimal level of respiratory depression and shouldn't actually be used to cause full alertness. It shouldn't actually be given just because the patient is "lethargic", unless by lethargic you mean they are breathing

Up Vote Up Vote ×
+ Add a Comment