Articles: opioid-analgesics.
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Pediatric emergency care · Dec 2021
Electrocardiographic Changes in Children With Acute Opioid Poisoning: A Cross-Sectional Study.
Opioid poisoning in children is a common pediatric emergency in Iran. The emergence and spread of new synthetic opioids have come up with new consequences in case of toxicity. In this study, we aimed to evaluate electrocardiographic changes in children with acute opiate poisoning. ⋯ Electrocardiogram changes due to acute opioid toxicity in children are not common, although in the case of methadone poisoning, long QT interval and associated arrhythmias should be anticipated. Moreover, because of life-threatening effects of opioids such as respiratory insufficiency and decreased consciousness, it is necessary to be prepared for these conditions.
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Acute pain from a vaso-occlusive crisis (VOC) is a leading reason patients with sickle cell disease (SCD) visit the emergency department (ED). Prior studies suggest that women and men receive disparate ED treatment for acute pain in EDs. We aim to determine sex differences in analgesic use among patients with SCD presenting to the ED. ⋯ In this nationally representative sample of ED visits among patients with SCD, there was no conclusive evidence of sex disparities in opioid prescribing. Though there is evidence of a trend signaling that male patients with SCD were more likely than female patients to be prescribed an opioid.
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Philadelphia, Pennsylvania, is an urban epicenter of the opioid epidemic, and inappropriate opioid prescribing remains a top concern. To help address this issue, the Philadelphia Medicaid Opioid Prescribing Initiative, a type of community quality collaborative, mailed thousands of local Medicaid providers an individualized prescribing report card in 2017 and 2018. ⋯ Using Medicaid pharmacy claims, the extensive variation in prescribing measures within and across specialties is also illustrated. The report card's implementation points to the potential value of collaborations between public health departments and Medicaid managed care organizations and can provide insight for other locally grown policies.
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Fentanyl is a high potency opioid that has become an increasingly large proportion of the illicit drug supply. Fentanyl overdoses and deaths, including in pediatric patients, has concomitantly increased. ⋯ Providers should be aware of these illicit tablets, know not to assume they are pharmaceutical, and consider the risk they pose to pediatric patients through exploratory ingestion or misuse. Further inquiry, including social investigation, should be considered for pediatric patients presenting with reported oxycodone ingestion, especially blue "M30" pills.