Opioid poisoning
Complete SOAP example
Example narrative
38-year-old man from HOME with unstable housing, found unresponsive after suspected fentanyl use. Bystander reports last seen awake 10 minutes earlier and gave one community naloxone dose. Co-ingestants unknown.
Primary survey identifies slow ineffective respirations with pulse. Patient found supine beside drug paraphernalia; pinpoint pupils and reduced LOC noted. BGL and serial vitals obtained; no major trauma identified.
Differential considerations: 1) opioid poisoning, 2) mixed substance poisoning, 3) intracranial or metabolic cause of reduced LOC. Immediate ventilatory compromise.
Airway positioning and ventilation support initiated, followed by naloxone per guideline. Respirations, oxygenation and LOC improved and were monitored for recurrence. Transported; bystander/EMS doses, response and uncertainty handed over.