Ep88 - Naloxone in Cardiac Arrest?

The EMS Lighthouse Project

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Howdy, y'all, I'm Dr Jeff Jarvis, and I'm the host of the EMS lighthouse project podcast, but I'm also the medical director for the new EMS system we're building in Fort Worth Texas. We are looking for an experienced critical care paramedic who is an effective and inspiring educator to lead the initial and continuing training and credentialing of a new team of Critical Care Paramedics who will be responding to our highest acuity calls. The salary is negotiable but starts between $65,000 and $80,000 a year for this office position. Whether y'all wear cowboy boots or Birkenstocks, Fort Worth can be a great place to live and work. So if you're ready to create a world-class EMS system and change the EMS world with us, give us a call at 817-953-3083, take care y'all.

Do you give naloxone to patients who are in cardiac arrest? Should you? Can it possibly provide any benefit at all once you are already providing effective ventilations? Well, Dr. Jarvis certainly thought not. He might have even thought it out loud. Like, loudly out loud.

Based on two recent papers looking directly at this question, perhaps he needs to eat some crow and shine the bright light of science on his own damn practice.

Citations:

1. Strong NH, Daya MR, Neth MR, Noble M, Sahni R, Jui J, Lupton JR: The association of early naloxone use with outcomes in non-shockable out-of-hospital cardiac arrest. Resuscitation. 2024;August;201:110263.

2. Dillon DG, Montoy JCC, Nishijima DK, Niederberger S, Menegazzi JJ, Lacocque J, Rodriguez RM, Wang RC: Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. JAMA Netw Open. 2024;August 1;7(8):e2429154.

3. Niederberger SM, Crowe RP, Salcido DD, Menegazzi JJ: Sodium bicarbonate administration is associated with improved survival in asystolic and PEA Out-of-Hospital cardiac arrest. Resuscitation. doi: 10.1016/j.resuscitation.2022.11.007 (Epub ahead of print).

4. Wampler DA: Naloxone in Out-of-Hospital Cardiac Arrest—More Than

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