Podcast 602: Post-Narcan Observation - The Emergency Medical Minute

Podcast 602: Post-Narcan Observation

Contributor: Donald Stader, MD

Educational Pearls:

  • Not uncommon for patients presenting after opiate overdose and narcan administration to be observed for 4-6 hours
  • This has been based more on tradition than evidence
  • Observation periods for overdose may vary based on the opiate(s) used
  • Fentanyl and heroin have half lives of about 2 hours, while oxycodone and methadone have significantly longer half lives. 
  • HOUR trial attempted to externally validate a scoring tool for stratification of low risk patients appropriate for discharge after 1 hour


Clemency BM, Eggleston W, Shaw EW, Cheung M, Pokoj NS, Manka MA, Giordano DJ, Serafin L, Yu H, Lindstrom HA, Hostler D. Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study. Acad Emerg Med. 2019 Jan;26(1):7-15. doi: 10.1111/acem.13567. Epub 2018 Dec 28. PMID: 30592101.

Summarized by Will Dewispelaere, MD | Edited by Erik Verzemnieks, MD

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