An interesting concept, and laudable that needle-less approaches for these tricky patients (dodgy veins, high risk of blood borne disease) are being trialled – I have written on intranasal application of medication previously.
I had a read of the paper accessed via my uni library (so that’s where all the tuition fees end up), seemed decent enough on first glance.
Two questions did arise though:
- In my experience, for a nebuliser to work, the mask (and therefore the patient) needs to be upright. Most patients who would require ‘naloxonisation’ would present lying down. I am not a fan of wrestling patients, deadweight or not. Is there a way of administering a nebule whilst the patient is in a horizontal position?
- Opiates/opioids have the effect of decreased respiration – both rate and depth. I’m sure this would have an effect on the uptake of the medication. It may be a good addition to include a T-piece, which would enable ventilatory support via a Bag-Valve Mask, thus increasing respiration depth and rate, and amount of naloxone administered.