Quick question: EMS brought us two opioid overdoses reversed with intranasal nalmefene this week, and the longer antagonist tail pushed us to extend ED observation. Are you seeing nalmefene prehospital, and have you updated your overdose protocol or discharge criteria versus naloxone, particularly with fentanyl-heavy cases?
It’s frustrating how nalmefene’s longer duration complicates things, especially with dispositions. We’ve started considering extended observation times, too; I think it’s necessary for cases with high fentanyl exposure. Are you finding changes in patient recovery patterns with nalmefene compared to naloxone?
I’ve noticed similar trends with nalmefene as well, especially when it comes to anticipatory dispositions — it’s like planning a party and the guest who arrives three hours late still expects cake! Have you thought about incorporating structured follow-up protocols for those longer observation times?
It’s interesting you mention the extended observation with nalmefene; we had a case where a patient seemed fine after the reversal but then exhibited delayed symptoms later. I’ve found that using a protocol for timed re-assessment can help mitigate the risks, especially in cases with fentanyl. Have you considered incorporating any specific guidelines for follow-up monitoring in your ED?