Article Text

Download PDFPDF
Joint RCEM and NPIS best practice guideline: assessment and management of acute opioid toxicity in adults in the emergency department
  1. Matthew Blundell1,
  2. Rupinder Gill1,
  3. Ruben Thanacoody2,
  4. Christopher Humphries3,
  5. David M Wood4,5,
  6. Paul I Dargan4,5
  1. 1Emergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
  2. 2National Poisons Information Service (Newcastle), Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  3. 3The University of Edinburgh Centre for Cardiovascular Science, Edinburgh, UK
  4. 4Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK
  5. 5Faculty of Life Sciences and Medicine, King's College London, London, UK
  1. Correspondence to Dr Matthew Blundell, Emergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK; matthew.blundell{at}gstt.nhs.uk

Abstract

The Royal College of Emergency Medicine Toxicology Special Interest Group in collaboration with the UK National Poisons Information Service and the Clinical Toxicology Department at Guy’s and St Thomas’ NHS Foundation Trust has produced guidance to support clinicians working in the ED with the assessment and management of adults with acute opioid toxicity.

Considerations regarding identification of acute opioid toxicity are discussed and recommendations regarding treatment options and secondary prevention are made. There is a focus on making recommendations on the best available evidence.

  • guidelines
  • assessment
  • toxicology
  • emergency department

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Handling editor Gene Yong-Kwang Ong

  • X @cp_humphries, @dmwood24

  • Contributors MB, RG, DMW, CH and PID—substantial contributions to the conception and design of the work. MB, RG, DMW, RT, CH and PID—drafting the work and reviewing it critically. MB, DMW, RT, CH and PID—final approval of the version to be published. MB, DMW, RT, CH and PID—agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The college recognises that patients, their situations, emergency departments and staff all vary. This guideline cannot cover all possible scenarios. The ultimate responsibility for the interpretation and application of this guideline, the use of current information and a patient’s overall care and well-being resides with the treating clinician.

  • Competing interests MB—unpaid member of RCEM Toxicology Advisory Group. RG has no declarations of interest. DMW is a member of the UK Advisory Council on the Misuse of Drugs and an expert advisor to the European Monitoring Centre for Drugs and Drug Addiction and the United Nations Office on Drugs and Crime. He is also a clinical coordinator at the UK National Confidential Enquiry into Patient Outcomes and Death (NCEPOD), and on the editorial board of the Journal of Medical Toxicology. His work on these guidelines was independent of his roles with these organisations. RT—his work on these guidelines was in his role as director of NPIS (Newcastle). CH is an editor for the Emergency Medicine Journal, has received payments from Elsevier for educational articles, has been reimbursed for travel expenses by RCEM and is a recipient of grants from the Centre for Precision Cell Therapy for the Liver. His work on these guidelines was in his role as a member of the RCEM Toxicology Special Interest Group. PID is an adviser to the UK Advisory Council on the Misuse of Drugs, the European Monitoring Centre for Drugs and Drug Addiction the United Nations Office on Drugs and Crime, and the WHO. He is also a commissioner to the UK Commission Human Medicines, on the senior editorial board of Clinical Toxicology, and is the president elect of the European Association of Poisons Control Centres and Clinical Toxicologists. His work on these guidelines was independent of his roles with these organisations.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.