Refusals After Prehospital Administration of Naloxone during the COVID-19 Pandemic.

TitleRefusals After Prehospital Administration of Naloxone during the COVID-19 Pandemic.
Publication TypeJournal Article
Year of Publication2021
AuthorsGlenn MJ, Rice AD, Primeau K, Hollen A, Jado I, Hannan P, McDonough S, Arcaris B, Spaite DW, Gaither JB
JournalPrehosp Emerg Care
Volume25
Issue1
Pagination46-54
Date Published2021 Jan-Feb
ISSN Number1545-0066
KeywordsAdult, Aged, COVID-19, Emergency Medical Services, Female, Humans, Incidence, Male, Middle Aged, Naloxone, Narcotic Antagonists, Pandemics, Retrospective Studies, SARS-CoV-2
Abstract

OBJECTIVE: To determine if COVID-19 was associated with a change in patient refusals after Emergency Medical Services (EMS) administration of naloxone.

METHODS: This is a retrospective cohort study in which the incidence of refusals after naloxone administration in a single EMS system was evaluated. The number of refusals after naloxone administration was compared across the before-pandemic interval (01/01/20 to 02/15/20) and the during-pandemic interval (03/16/20 to 04/30/20). For comparison the incidence of all other patient refusals before and during COVID-19 as well as the incidences of naloxone administration before and during COVID-19 were also reported.

RESULTS: Prior to the widespread knowledge of the COVID-19 pandemic, 24 of 164 (14.6%) patients who received naloxone via EMS refused transport. During the pandemic, 55 of 153 (35.9%) patients who received naloxone via EMS refused transport. Subjects receiving naloxone during the COVID-19 pandemic were at greater risk of refusal of transport than those receiving naloxone prior to the pandemic (RR = 2.45; 95% CI 1.6-3.76). Among those who did not receive naloxone, 2067 of 6956 (29.7%) patients were not transported prior to the COVID-19 pandemic and 2483 of 6016 (41.3%) were not transported during the pandemic. Subjects who did not receive naloxone with EMS were at greater risk of refusal of transport during the COVID-19 pandemic than prior to it (RR = 1.39; 95% CI 1.32-1.46).

CONCLUSION: In this single EMS system, more than a two-fold increase in the rate of refusal after non-fatal opioid overdose was observed following the COVID-19 outbreak.

DOI10.1080/10903127.2020.1834656
Alternate JournalPrehosp Emerg Care
PubMed ID33054530
Faculty Reference: 
Brittany Arcaris, MD
Joshua B. Gaither, MD, FACEP
Melody J. Glenn, MD
Philipp L. Hannan, MD
Keith Primeau, MD, MPH
Amber Rice, MD
Daniel W. Spaite, MD
Weight: 
0