Circulation

Cardiovascular complications are uncommon after opioid poisoning. If hypotension is problematic, start intravenous fluid resuscitation.

Loperamide, methadone and oxycodone poisonings can cause QT-interval prolongation and torsades de pointes. If the QT interval is prolonged, commence continuous ECG monitoring and assess serial 12-lead ECGs, and manage urgently according to Treatment for QT-interval prolongation and torsades de pointes.

Cardiorespiratory arrest after opioid poisoning is usually due to prolonged hypoxia—follow advanced life support protocols1.

1 The Australian Resuscitation Council has cardiorespiratory arrest flowcharts for adults and children.Return