Pre-Hospital Administration of Naloxone without Indication in Opioids Overdose; a medical error

Background: Overdose of opioids is one of the most common medical problems that requires medical staff to have enough information for minimizing its mortality. Naloxone is used as an antidote to reverse the signs and symptoms of opioid toxicity such as respiratory depression. Indications for naloxone administration in opioid poisoning are well known. While naloxone administration without indication has some complications and may put financial burden on the patient’s shoulder, it can be also considered a medical error. The aim of this study was to evaluate the frequency of pre-hospital administration of naloxone without an accurate indication for the poisoned patients. Methods: In this retrospective cross-sectional study, all poisoned patients hospitalized in northwest toxicology center of Iran who had received naloxone before hospitalization were included. Data collection was performed by reviewing patients’ files. Since indications for naloxone in overdose of opioids are well known, any other administrations out of the specified indications is considered as prescriptions without indication. Results: Our results show that 178 of the study subjects were men and 22 were women. Naloxone was administered in 57% of the patients that of them 31.57% had specified indication. Among these patients, 19.44% had respiratory rate less than 12 breaths per minute, 66.66% had decreased level of consciousness, and 13.88% had both conditions. All patients with oxygen saturation less than 90% had respiratory rate below 12. Conclusion: Results of this study showed a high administration rate of naloxone without an appropriate indication. We suggest that it is necessary to reduce such medication errors by continues training of healthcare providers.