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The following is a summary of “Risk of Delayed Intubation After Presumed Opioid Overdose in the Emergency Department,” published in the March 2025 issue of Annals of Emergency Medicine by McCabe et al. 

Researchers conducted a retrospective study to determine the optimal monitoring duration before non-ICU admission for individuals with presumed opioid overdoses, considering the rising prevalence of fentanyl analogs and potent synthetic opioids.  

They performed a secondary analysis of the Fentalog Study under the American College of Medical Toxicology’s Toxicology Investigators Consortium and identified individuals arriving at the emergency department with acute opioid overdose, collected clinical data, and confirmed substances through biological testing. This analysis evaluated the risk of “delayed intubation” (any intubation occurring after 4 hours of emergency department arrival).  

The results showed that out of 1,591 individuals included, 9 (0.6%) required delayed intubation. Among them, 8 had non-respiratory-related conditions contributing to intubation, and 1 individual had only respiratory-related conditions, presented with respiratory acidosis, and received a total of 6.4 mg of naloxone before intubation (any intubation occurring after 4 hours of emergency department arrival).  

Investigators concluded that delayed intubation after extended observation of patients with presumed opioid overdose was exceptionally uncommon. 

Source: annemergmed.com/article/S0196-0644(25)00060-5/abstract