Original Research: Is Your Outpatient Office Prepared to Manage an Opioid Overdose?

Background: Outpatient facilities, such as family and adult practice offices, psychiatric offices, and substance use treatment centers, should be equipped to manage medical emergencies and facilitate hospital transfers. Clinics that treat patients with opioid use disorder must be especially prepared to address respiratory arrest due to opioid overdose.

Purpose: The objective of this integrative review was to identify emergency response initiatives already investigated or developed that could be adapted to address opioid-related medical emergencies in the outpatient adult treatment setting.

Methods: Initial and updated literature searches were conducted using MEDLINE and PubMed. These searches yielded 207 and 60 articles of interest, respectively, and a total of 6 and 18 were selected for retrieval. Of these, 5 and 8, for a total of 13, met the inclusion criteria.

Results: We found few publications in the mental health literature to inform or guide outpatient practitioners in preparing their offices for emergencies. This integrative review draws from all areas of the medical literature to identify emergency response strategies that have been developed for outpatient settings. We identified 4 major themes in office emergency preparedness: simulation training, response team organization, equipment readiness, and emergency action protocols.

Conclusion: These 4 themes can provide guidance for improving readiness in medical offices, and in ambulatory mental health and substance use clinics. Researchers will need to develop emergency response algorithms that address these themes and assess patient outcomes.