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Etiologic Factors 33 ^5 35 35 36 37 38 39 39 39 I. I n t r o d u c t i o n In t h e past t h e t r e a t m e n t of a c u t e h e r o i n t o x i c i t y ( m o r e c o m m o n l y k n o w n as heroin overdose or j u s t O D ) , was mainly confined t o t h e emergency r o o m s of large city hospitals. As heroin use has spread, however, from t h e inner city t o s u b u r b a n , small t o w n , and even rural areas, m o r e and m o r e physicians m a y e n c o u n t e r t h e p h e n o m e n o n in outlying hospitals, clinics, and occasionally in their offices.

As heroin use has spread, however, from t h e inner city t o s u b u r b a n , small t o w n , and even rural areas, m o r e and m o r e physicians m a y e n c o u n t e r t h e p h e n o m e n o n in outlying hospitals, clinics, and occasionally in their offices. CompliĀ­ cating t h e picture is t h e relative inexperience of m a n y of t h e n e w users and t h e p o o r b u t very variable quality of t h e heroin o n t h e streets which is conducive t o individuals using s u d d e n l y m o r e t h a n their tolĀ­ erance level.

Oral airway. An oral airway w i t h o u t a pharyngeal e x t e n s i o n is simple t o use and e x p e d i t e s m o u t h t o m o u t h resuscitation. S o m e physicians prefer an o r o p h a r y n g e a l airway if t h e o r o p h a r y n g e a l reflexes are absent. However, as t h e p a t i e n t regains consciousness, such an airway m a y i n d u c e vomiting. These airways, as w i t h o t h e r m e c h a n i c a l devices, should be used only if instantly available. Otherwise fingers holding t h e t o n g u e forward suffice.

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