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Opioid Intoxication, Pediatric

Pamela D. Fazzio, MD and Jeannine Del Pizzo, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Opioids are a group of natural and synthetic substances used both illicitly and for prescription analgesia.

  • Opioids include:

    • Opiates—naturally occurring in the opium poppy (e.g., codei...

DIAGNOSIS

HISTORY

  • Neonate: maternal history of drug use

  • Young child: opioids present in home

  • Adolescents:

    • Recreational drug use

    • Depression/suicidality

    • Involvement with law enforcement (ingestion as attempt ...

TREATMENT

GENERAL MEASURES

Intoxication/overdose 
  • ABCDEs (airway, breathing, circulation, disability, exposure)

  • Support respiratory failure with bag-mask ventilation and 100% FiO2, escalate to intubation...

ONGOING CARE

PROGNOSIS

  • Intoxication/overdose

    • With adequate early treatment, patients with uncomplicated overdoses do well—key is to prevent respiratory arrest.

    • 33,000 deaths from opioids, including presc...

ADDITIONAL READING

  • Compton WM, Jones CM, Baldwin GT. Relationship between nonmedical prescription-opioid use and heroin use. N Engl J Med.  2016;374(2):154–163. [View Abstract on OvidInsights]

  • Fin...

CODES

ICD9

  • 965.01 Poisoning by heroin

  • 292.0 Drug withdrawal

  • 779.5 Drug withdrawal syndrome in newborn

  • 779.4 Drug reactions and intoxications specific to newborn

  • E935.0 Heroin causing adverse effects in the...

FAQ

  • Q: What causes false-positive and false-negative urine drug screens?

  • A: Opiates are typically detected in the urine up to 1 to 4 days after exposure. A dilute sample decreases test sensitivity. Rif...

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