Elsevier

Annals of Emergency Medicine

Volume 21, Issue 11, November 1992, Pages 1326-1330
Annals of Emergency Medicine

Original contribution
Is admission after intravenous heroin overdose necessary?

https://doi.org/10.1016/S0196-0644(05)81896-7Get rights and content

Study objectives:

To investigate the time of onset and incidence of complications in patients presenting to the emergency department with an IV heroin overdose and the need for routine admission of such patients.

Methods:

A retrospective chart review of hospital and emergency medical service records of 124 patient visits involving IV heroin overdose over a five-month period. We also reviewed the death certificates of 115 persons having succumbed to a narcotic overdose over a 44-month period and compared these with our hospital records.

Setting:

Urban county hospital.

Type of participants:

Patients presenting to the ED with an IV heroin overdose.

Results:

There were five deaths in the ED, 12 hospital admissions, and 107 patients who were discharged home. Neither delayed onset of pulmonary edema nor recurrence of respiratory depression was observed. Of the 115 persons having succumbed to a narcotic overdose, eight had been seen previously at our hospital for a heroin overdose. There is no evidence that any of these eight deaths would have been prevented by a 24-hour hospital observation period.

Conclusion:

Complications arising from an IV overdose of heroin are usually evident on arrival in the ED or shortly thereafter. On retrospective review we have found no evidence that admission to the hospital and 24 hours of observation are of benefit to patients who are awake, alert, and lacking evidence of pulmonary complications after an IV heroin overdose.

References (14)

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Presented at the Society for Academic Emergency Medicine Annual Meeting in Washington, DC, May 1991.

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