About this episode

This episode discusses the findings of a study on delayed intubation after opioid overdose treatment with naloxone.

Contributor: Aaron Lessen, MD Educational Pearls: How long do we need to watch patients with a presumed overdose who were treated with naloxone in the field? A 2025 study in the Annals of Emergency Medicine took a look at this question Methods Prospective, multi-institutional cohort study Included ED patients with suspected acute opioid overdose with biologic testing to confirm substances. This paper performed a secondary analysis evaluating the risk of "delayed intubation," defined as intubation occurring >4 hours after ED arrival. Results 1,591 patients with presumed opioid overdose were included. Delayed intubation occurred in only 9 patients (0.6%). 8 of the 9 cases had non-respiratory causes contributing to intubation. Only 1 patient had respiratory-related deterioration, presenting with respiratory acidosis after receiving 6.4 mg naloxone prior to intubation. Key Takeaway Delayed respiratory deterioration requiring intubation after 4 hours of ED monitoring is extremely rare, suggesting prolonged monitoring may not be necessary for most stabilized overdose patients. How else can we mitigate risk? Give patients take-home naloxone at discharge and educate them on how to use it…

More episodes of Emergency Medical Minute

• Podcast 1003: Nasal Intubation · April 27, 2026 · 9 min
• Podcast 1002: Elder Agitation · April 20, 2026 · 4 min
• Podcast 1001: Acute Intermediate Risk Pulmonary Embolism · April 13, 2026 · 3 min
• Celebrating 1000 Medical Minutes · April 3, 2026 · 1h 29m
• Podcast 1000: Cool Water · March 30, 2026 · 3 min
• Podcast 999: Right vs Left Internal Jugular Access · March 23, 2026 · 3 min

Explore listener stats, chart rankings, contacts and more on the Emergency Medical Minute podcast page.