--- title: Airway Management and the Overdose Patient description: When treating an overdose patient, the normal signs of airway compromise may be difficult to recognize. Here are the steps involved in airway management. image: https://blog.sscor.com/hubfs/Blog/airway-management-overdose-patient.jpg --- [![dark-header.jpg](https://blog.sscor.com/hs-fs/hub/212347/file-1107077240.jpg?width=940&name=file-1107077240.jpg "dark-header.jpg")](https://www.sscor.com/) ## **Thank you for visiting the SSCOR Blog.** Whether you're in a Hospital or EMS setting, this is the place for you. We'll share information on current industry news, tips, as well as the latest and greatest in SSCOR products. Our hope is that this blog is not only informative but a collaborative and open forum for you to share your thoughts on developing opportunities and challenges within your profession. Subscribe. Share your thoughts. Enjoy. -SSCOR Team   # [Airway Management and the Overdose Patient](https://blog.sscor.com/airway-management-and-the-overdose-patient) Posted by [Sam D. Say](https://blog.sscor.com/author/sam-d-say) Oct 10, 2024 8:00:00 AM 3 min read - [![LinkedIn Social Icon](https://cdn2.hubspot.net/hub/142915/file-2628248555-png/images/icons/linkedin-small.png) ](https://blog.sscor.com/airway-management-and-the-overdose-patient#) 0 - [![Facebook Social Icon](https://cdn2.hubspot.net/hub/142915/file-2623658044-png/images/icons/fb-small.png) ](https://blog.sscor.com/airway-management-and-the-overdose-patient#) 0 ![Airway Management and the Overdosed Patient - Things to look for](https://blog.sscor.com/hs-fs/hubfs/Blog/airway-management-overdose-patient.jpg?width=700&name=airway-management-overdose-patient.jpg "Airway Management and the Overdosed Patient - Things to look for") Anyone in the medical field can attest to an epidemic sweeping our country: [opioid overdose](https://www.hhs.gov/opioids/statistics/index.html) . This lethal condition has touched every region of the US and is now a [leading cause of death](https://ashpublications.org/ashclinicalnews/news/4317/Opioid-Overdose-Tops-List-of-Leading-Causes-of). It’s been proclaimed a national health crisis. If you're an EMS responder, it is simply a matter of time before you are faced with this situation.    Patients experiencing opioid overdose share many of the same life-threatening symptoms of other drugs: the most critical being respiratory depression, the inability to protect the airway, and respiratory arrest. So, let's review the critical steps involved in airway management of the overdose patient.    [![Guide: Portable Emergency Suction: A Critial Tool In Avoiding Aspiration Pneumonia](https://no-cache.hubspot.com/cta/default/212347/2f1501c2-bb40-46f8-a1de-c029ad5be75b.png)](https://cta-redirect.hubspot.com/cta/redirect/212347/2f1501c2-bb40-46f8-a1de-c029ad5be75b)   ## **Recognize That They Have A Tenuous Airway** When treating an overdose patient, some of the normal signs and symptoms of airway compromise may be difficult to recognize. The patient may have a decreased level of consciousness—one of the [primary indicators of respiratory failure](https://blog.sscor.com/airway-physiology-a-brief-review)—so pay attention to other signs of impending failure:   - Tachycardia, typically greater than 130 bpm - Pale, diaphoretic skin - Decreased oxygen saturation, even after O2 therapy - Difficulty speaking - Absent breath sounds - Abnormal respiratory patterns - Cyanosis Stay alert for these signs of respiratory failure. It can happen rapidly, with little notice, and will be especially challenging to identify in the overdosed patient.   ## **What’s the Pattern?** Sometimes the respiratory pattern can [indicate the underlying issue](https://blog.sscor.com/respiratory-emergencies-abnormal-respiratory-patterns-and-what-they-indicate). Here's a quick review of abnormal breathing patterns you may see in the overdose patient:   - **Cheyne–Stokes**: A cyclical pattern that includes a progressive increase in rate and depth, followed by periods of apnea; often associated with drug overdose, acidosis, and increased intracranial pressure. - **Apneustic breathing:** Prolonged periods of gasping inspiration, followed by brief but ineffective expiration, typically at a rate of 1 to 2 breaths per minute. - **Hyperventilation**: An increased rate and depth (typically 20 to 30 per minute), resulting from fever, exertion, anxiety, acid-base imbalance, or damage to the midbrain. - **Agonal respirations**: An abnormal pattern of slow, shallow, deep, or gasping respirations. - **Apnea**: The absence of respirations, usually lasting greater than 15 seconds. ## **Arrive Prepared** Anytime you respond to a possible overdose, you should automatically be thinking "Respiratory emergency!" Protecting the airway is [your primary objective](https://blog.sscor.com/oral-suctioning-procedure-basics-what-you-need-to-know); the Narcan® can't work if the patient isn't breathing. So bring the proper equipment when you arrive on scene. Here's what you'll need:   - Supplemental oxygen with adjuncts (non-rebreather mask) - Intubation equipment - Various sizes of tubes - Airway adjuncts (NPA/OPA) - Accessories (lubricating gel for nasal intubation) - Portable suction unit - Range of suction catheters (flexible, rigid, and large-bore evacuation) [![New: Free Emergency Aspirator Purchasing Guide for Hospitals](https://no-cache.hubspot.com/cta/default/212347/8b3f08ff-a209-4f08-b702-68de84bac45b.png)](https://cta-redirect.hubspot.com/cta/redirect/212347/8b3f08ff-a209-4f08-b702-68de84bac45b)   ## **The Importance of Suction** Airway compromise is one of the greatest risks in the overdose patient. And one of your most important tools is your portable suction machine. Aspiration is [always a possibility](https://blog.sscor.com/tips-for-avoiding-aspiration-pneumonia), especially in the unconscious patient, and the only way to clear the airway is through prompt, effective suctioning.   That is why it's imperative that you [bring the suction unit](https://blog.sscor.com/five-reasons-paramedics-should-bring-portable-suction-on-every-call) with you on every overdose call. The unit is of no use if it's left on the truck, so make the unit part of your ALS assemblage, either by assigning someone or by incorporating a small, portable unit in with the airway bag.    Treating the overdose patient has unfortunately become commonplace in EMS. So be sure you are prepared by recognizing the tenuous airway, having the right tools on hand to manage it, and by always carrying your portable suction unit with you.   *Editor's Note: This blog was originally published in May 2022. It has been re-published with additional up to date content.* Topics: [Airway management](https://blog.sscor.com/topic/airway-management) ![Author Photo](https://blog.sscor.com/hs-fs/hubfs/SDS2-648378-edited.jpg?width=70&name=SDS2-648378-edited.jpg) ## AboutSam D. Say Sam D. Say is owner and CEO of SSCOR, Inc., a medical device manufacturer specializing in emergency battery operated portable suction devices for the hospital and pre-hospital settings. Mr. Say has been involved in developing product for healthcare providers for over 35 years. His passions include contributing to the management of the patient airway and providing solutions that save lives in difficult conditions. 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