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

Opioids overdose is one of the most common medical problems that necessitate medical staff to have enough information to decrease mortality. Naloxone is used as an antidote to reverse the signs and symptoms of opioid toxicity such as respiratory depression, provided no contraindications encountered. Indications for naloxone administration in poisonings are well known. While naloxone administration without indication has some complications and may put financial burden on the patient, it can also be considered a medical error. The aim of this study was to evaluate the frequency of pre-hospital naloxone administration without indication among poisoned patients. 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 the patients' files. Since indications for naloxone administration in opioids overdose are well known, any other administrations out of the specified indications were considered as prescriptions without indication. In this study, 178 of the patients were men and 22 were women. Naloxone was administered in 57% of the patients; 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. Results of this study showed that a high rate of naloxone was administered without indication. It is necessary to reduce such medication errors by continues training of healthcare providers.