Enroute phaseScenario:The paramedic crew is dispatched to a…
Enroute phaseScenario:The paramedic crew is dispatched to a public library for a 34-year-old male who is reported to be unconscious in the restroom. The call was received at 1217. The response time is estimated at 6 minutes. The paramedic is partnered with an EMT, and a BLS fire engine crew is also en route. The temperature is 66°F (19°C), with clear skies and light pedestrian traffic. The caller, a library staff member, reports the patient was found slumped on the floor and is “barely breathing.” No known medications or allergies have been reported. OnScene phaseScenario:The patient (approx. 80 kilograms) is found supine on the floor of a public restroom stall. He is unresponsive, pale, and breathing slowly. His airway is partially obstructed by relaxed oral tissues. A tourniquet is seen on his left arm with a syringe nearby. No signs of trauma are present. He does not respond to verbal stimuli but withdraws from pain.Initial vital signs are: blood pressure is 102/64 mmHg, pulse is 56 bpm, respirations are 6 per minute and shallow, SpO₂ is 86% on room air, temperature is 97.5°F (36.4°C). Pupils are 1 mm and minimally reactive. BVM ventilation is initiated with high-flow oxygen. PostScene phaseScenario: After naloxone is administered intranasally, the patient becomes more alert and begins breathing spontaneously. His respiratory rate increases to 14 breaths per minute, and SpO₂ rises to 96% on supplemental oxygen. He is drowsy, slightly confused, and speaks in short sentences. He denies using any drugs but agrees to transport. IV access is established, and the patient remains on continuous monitoring during transport.Updated vitals: BP 110/70, HR 72, RR 14, SpO₂ 96% on nasal cannula at 4 L/min, Temp 98.1°F (36.7°C).What complication is most likely to occur during transport following opioid reversal?