Unique Plan Description: Naloxone for Overdose (non-pruritus)
Plan Selection Display: Naloxone for Overdose (non-pruritus)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2026-01-09 09:56:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2026-01-09 09:56:59
Available at all facilities: No

Naloxone for Overdose (non-pruritus)
Admit/Discharge/Transfer
	Admit to Critical Care Inpatient Status (MH)
		T;N, Anticipated LOS 2 midnight or more, Consult Intensivist: Pulmonary Medicine Specialist
Vital Signs
	Vital Signs
		T;N, Q1H
			Comment: Minimum q 1 hour while on infusion and prn rate changes(to include BP, RR, HR, SP02, ETC02)
Laboratory
	Blood Gases Arterial (ABG) - MH/WH/JE
		T+1;0400, Routine, Q24H, spec type = Blood
	Blood Gases VENOUS (VBG)
		T+1;0400, Routine, Q24H, spec type = Blood
Diagnostic Tests
	ECG
		
IV Solutions
		Enter starting rate of Naloxone-60% of initial IVP/bolus dose/treatment (usual rates 0.25-6.25mg/hr)Discussing the [_(Provider to enter)____mg/hr: portion(NOTE)*
	naloxone 4mg/100mL NS 0.9%
		4 mg, EVERY BAG, 0.2 mg/hr
		100 mL, IV, Routine, Start: T;N, Goal: RASS 0 to -1 RR> 12, Increment Increase: 0.2 mg/hr, Increment Decrease: 0.2 mg/hr, Increment Freq: 15 min(s), Max Dose: 8 mg/hr
			Comment: Monitor for symptoms of opioid withdrawal. If withdrawal symptoms occur, Stop infusion and notify provider; Notify provider if at max dose and unable to maintain goal.
	Communication to HOSPITAL RN
		T;N, See Comments
			Comment: Once patient maintaining goal, update provider. Once the provider gives order to stop infusion, decrease rate by half every hour until infusion is off. If patients Respiratory Rate or Responsiveness decreases, return to previous rate and attempt to decrease again in one hour.
Patient Care
	Cardiac Telemetry Monitoring
		T;N, Telemetry Indications: Drug Overdose/Alcohol Intoxication
			Comment: Naloxone
	Notify MD
		If RR <12, Rass < -1, or if signs of opioid withdrawal present (nausea, vomiting, sweating, severe pain, agitation, dilated pupils, tachypnea, tachycardia, tremors and increased blood pressure)
	Assess RASS
		T;N, minimum q 1 hour while on continuous infusion and prn for any dosage adjustments as directed by provider.
	Neurological Assessment-Focused
		T;N
			Comment: minimum q 1 hour while on continuous infusion and prn for any dosage adjustments as directed by provider.
	Pain Assessment
		T;N, minimum q 1 hour while on continuous infusion and prn for any dosage adjustments as directed by provider.
	Respiratory Assessment-Focused
		T;N, Q1H
			Comment: While on continuous infusion and PRN for any dosage adjustments as directed by the provider. Respiratory assessment to include effort and quality.
Therapies
	Continuous Pulse Oximetry Monitoring Check
		T;N, BID
	End Tidal CO2 (ETCO2) Monitoring
		T;N
			Comment: Continuous
Consults/Follow-up
	Pharmacy Consult
		Review of pain and sedation medications for possible adjustments
	Consult Social Work
		T;N, Evaluation

Oxygen Protocol
Therapies
Respiratory Therapy
	Oxygen Therapy
		T;N
	Pulse Oximetry Spot Check RT
		T;N, BID
	Continuous Pulse Oximetry Monitoring Check
		T;N, BID

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase