Trouble with Narcan

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Specializes in med surg.

Hello everyone! I am new to this site, and wanted to get feedback on narcan use from other people. Gave some ivp the other day for post surgery respiratory depression (RR

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Yep....she was going through a withdrawal. I've given it to people who come in with heroin OD and that's happened. The "narcotic use hx" said it all.

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Specializes in Hospice, Med/Surg, ICU, ER.

Uh huh....

You see this ALL THE TIME in an ER. An OD comes in, you push narcan, they come back almost immediately and BOY are they pizzed off!

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Specializes in ER (new), Respitory/Med Surg floor.

I just had to give narcan for the first time ever. Pt got a dose of dilaudid after already being on morphine 2 hours prior and her resp were 6/min. Jeeze she just kept getting lower and lower. Pushed narcan and in 2 min BAM back awake. She was all figity and anxious. She was more nervous everyone was around her kept calling for her husband but more scared. Then she calmed down. But wow that stuff works!

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Uh huh....

You see this ALL THE TIME in an ER. An OD comes in, you push narcan, they come back almost immediately and BOY are they pizzed off!

One of my coworkers once Narcan'd a heroin OD. She came up fighting and cussing him out, demanding (cleaned up) "What did you do???"

Answer: "Your high go bye-bye!"

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Specializes in Hospice, Med/Surg, ICU, ER.
One of my coworkers once Narcan'd a heroin OD. She came up fighting and cussing him out, demanding (cleaned up) "What did you do???"

Answer: "Your high go bye-bye!"

:rotfl: :rotfl: :rotfl:

Yup! At an ER I was a tech at (MANY yrs ago), we had one of our frequent flyers come in with a nasty 8" long laceration to his thigh. Of course, he acted like he was dying; demanding pain meds.

The attending that night was new to our facility (and thus didn't "know" the pt.) and ordered MS (I think) IVP; the RN that gave it pushed it REALLY slow. Later, I asked her why she did it that way and her answer was "I didn't want that stupid junkie SOB enjoying it!":lol2:

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Specializes in med surg.

Thank you so much! For awhile I thought I'd killed her! Apparently she told the doc/her family that she was "weaning off everything" when in reality she was not only taking her own med but her dead husband's meds too!!

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Specializes in med surg.

clee, I had to laugh at your post. I've noticed I can tell the addicts by how they respond to ivp narcs - the addicts looove the rush, and everyone else is mad and wants the next dose slower!! lol

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Specializes in Hospice, Med/Surg, ICU, ER.
clee, I had to laugh at your post. I've noticed I can tell the addicts by how they respond to ivp narcs - the addicts looove the rush, and everyone else is mad and wants the next dose slower!! lol

Uh huh. I still chuckle about it everytime I see an obvious drug-seeker in an ER.

I've never had to have IV opioids, but I have had some large doses of hydrocodone PO post a root-canal gone bad; If the feeling :uhoh3: of a normal opioid IVP is stranger than that, NO thank you!

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Specializes in Nephrology, Cardiology, ER, ICU.

I work in an inner city ER - give Narcan almost daily. You do have to be very careful with it because it can kill - it precipitates seizures. Folks with sz disorder (something you may not know in your unconcious ER pt), usually sz and can go to status quickly. With heroin OD's, you need to ensure your pt is in four point restraints PRIOR to giving Narcan if at all possible. Narcan is not a cure-all either - you may have to give more than one dose in order to keep their LOC up.

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never had a problem with narcan, at least yet. but I can see how this would happen. once gave a pt romazicon, and had he had a seizure. he had been taking ativan for an extended period and took an OD, was brought in by EMS, and ERP ordered romazicon. the results were awful. This was the only time I have had this happen.

We had an 80+ year old lady come in the the ER via EMS, once. Family thought she had a CVA, unresponsive, contracture-like extremities, pupils fixed. ERP suggested Narcan and almost immediately the LOL woke up and stated "you should have let me die"..., "when you are old, no one cares about you. They call to see if you need any food but you never see them". LOL was admitted and somehow she hoarded her meds and OD'd while in the hospital. Just goes to show, you have to make sure pts swallow their pills. LOL was sent to Greenleaf. I assume she is ok, haven't heard any different.

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Specializes in Hospice, Med/Surg, ICU, ER.
I work in an inner city ER - give Narcan almost daily. You do have to be very careful with it because it can kill - it precipitates seizures. Folks with sz disorder (something you may not know in your unconcious ER pt), usually sz and can go to status quickly. With heroin OD's, you need to ensure your pt is in four point restraints PRIOR to giving Narcan if at all possible. Narcan is not a cure-all either - you may have to give more than one dose in order to keep their LOC up.

Thanks for the tips r/t seizures! I'd left that tidbit buried deep in the recesses of my brain.:rolleyes: Man, that would have sucked to push narcan for the first time as a nurse and have my pt sz unexpectedly! :eek:

Also, thanks for the 4-point restraint advice as well.

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