Naloxone and Clinical Outcomes in Suspected Opioid-Associated Out-of-Hospital Cardiac Arrests - Report - MDSpire

Naloxone and Clinical Outcomes in Suspected Opioid-Associated Out-of-Hospital Cardiac Arrests

  • By

  • Ralph C. Wang

  • Jake Toy

  • Juan Carlos C. Montoy

  • Juliana Tolles

  • Paul F. Ehlers

  • J Joelle Donofrio-Odmann

  • James J. Menegazzi

  • Marianne Gausche-Hill

  • Robert M. Rodriguez

  • David G. Dillon

  • CAL-ROC Investigators

  • John M VanBuren

  • Nichole Bosson

  • Dustin W Ballard

  • Amelia M Breyre

  • Senai Kidane

  • Zita Konik

  • Mark Luoto

  • Kevin Mackey

  • John S Rose

  • Shira Schlesinger

  • Alexander Schmalz

  • Daniel Sheperd

  • Pranav Shetty

  • Reza Vaezazizi

  • Sachin Agarwal

  • Ann Johnson

  • Roger J Lewis

  • Jason McMullan

  • Stephen Sanko

  • Manish I Shah

  • Hernando Garzon

  • Daniel Nishijima

  • Debbie Y Madhok

  • Mary P Mercer

  • Christopher J Coyne

  • Christopher A Kahn

  • May 29, 2026

  • 0 min

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Impact of Naloxone on Outcomes in Suspected Drug-Related Cardiac Arrests

Overview

This study evaluates the association between naloxone administration by EMS and survival outcomes in patients with suspected opioid-associated out-of-hospital cardiac arrests (OA-OHCA). Findings suggest that naloxone may improve survival rates, highlighting the need for standardized protocols in EMS practices.

Background

The rise in drug overdose deaths, particularly from opioids, has led to an increase in out-of-hospital cardiac arrests (OHCAs) attributed to drug use. Despite naloxone's established role in reversing opioid-induced respiratory depression, its effectiveness in OA-OHCA remains uncertain. Understanding naloxone's impact on survival outcomes is crucial for improving emergency response protocols.

Data Highlights

This study utilized data from the California Resuscitation Outcomes Consortium (CAL-ROC) involving 173 EMS agencies, assessing outcomes from January 2021 to December 2022.

Key Findings

  • Naloxone administration by EMS was associated with improved survival to hospital discharge in suspected OA-OHCA patients.
  • Inclusion of naloxone in EMS protocols varies significantly across different agencies.
  • Previous studies have shown mixed results regarding naloxone's effectiveness in improving outcomes in OHCA.
  • The NACARDI tool demonstrated a sensitivity of 63.6% and specificity of 89.3% for identifying OA-OHCA.
  • Drug-related OHCAs have increased from less than 3% to up to 17% in recent years.

Clinical Implications

Emergency medical services should consider standardizing naloxone administration protocols for suspected OA-OHCA to potentially enhance survival outcomes. Continuous training and adherence to updated guidelines are essential for improving patient care in the field.

Conclusion

The study underscores the potential benefits of naloxone in improving survival rates in suspected OA-OHCA cases, advocating for further research and standardized EMS practices.

Related Resources & Content

  1. JAMA Network Open, 2023 -- Naloxone for Out-of-Hospital Cardiac Arrest Due to Opioid Toxicity
  2. 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - Professional Heart Daily | American Heart Association
  3. The Journal of Clinical Endocrinology & Metabolism — Is Intranasal Naloxone Effective in Mitigating Autonomic Failure Related to Hypoglycemia?
  4. conexiant — ECPR Shows Promise in Cardiac Arrest
  5. The Journal of Clinical Endocrinology & Metabolism — Impact of Intranasal Naloxone on Autonomic Dysfunction Related to Hypoglycemia in At-Risk Patients
  6. 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - Professional Heart Daily | American Heart Association
  7. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California | Emergency Medicine | JAMA Network Open | JAMA Network

Original Source(s)

Naloxone and Clinical Outcomes in Suspected Opioid-Associated Out-of-Hospital Cardiac Arrests

  • by Ralph C. Wang, Jake Toy, Juan Carlos C. Montoy, Juliana Tolles, Paul F. Ehlers, J Joelle Donofrio-Odmann, James J. Menegazzi, Marianne Gausche-Hill, Robert M. Rodriguez, David G. Dillon, CAL-ROC Investigators, John M VanBuren, Nichole Bosson, Dustin W Ballard, Amelia M Breyre, Senai Kidane, Zita Konik, Mark Luoto, Kevin Mackey, John S Rose, Shira Schlesinger, Alexander Schmalz, Daniel Sheperd, Pranav Shetty, Reza Vaezazizi, Sachin Agarwal, Ann Johnson, Roger J Lewis, Jason McMullan, Stephen Sanko, Manish I Shah, Hernando Garzon, Daniel Nishijima, Debbie Y Madhok, Mary P Mercer, Christopher J Coyne, Christopher A Kahn

  • May 29, 2026

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