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MAT ttachment F <br /> History Signs and Symptoms Differential <br /> • Opiate use disorder • Nausea/vomiting/diarrhea 0 Viral of Bacterial Infection <br /> • Recent use of opiate (IV or 0 Chills 0 Opiate Withdrawal <br /> oral) 0 Restlessness • Alcohol Withdrawal <br /> • Mydriasis <br /> • Body Aches <br /> • Runny Nose <br /> Patient presents with opioid <br /> withdrawal symptoms <br /> On scene with patient from initial <br /> EMS encounter or external referral <br /> As indicated in PEARLS <br /> Ondansetron 4mg YES Nausea and/or <br /> IV/lO/ODT/IM Vomiting? <br /> NO <br /> Exclusion Criteria YES <br /> Present? <br /> NO <br /> No Buprenorphine <br /> Exclusion Criteria indicated <br /> COWS scale>87 NO 10 Provide Harm Reduction <br /> • Methadone use within last 72 hours <br /> Resources,Education and <br /> • Unable to consent YES Contact Information <br /> • <br /> Unstable patients requiring <br /> • <br /> emergency interventions Obtain release of <br /> • Unwilling to provide name AND date patient information <br /> of birth and buprenorphine <br /> • Less than 18 years of age consent <br /> • Allergy to buprenorphine <br /> • <br /> Buprenorphine 16mg <br /> SL <br /> Reassess COWS scale after Do Not Administer <br /> 10 minutes NO 10 Additional Buprenorphine <br /> COWS scale>8? <br /> YES <br /> Buprenorphine 8mg <br /> SL <br /> REFER TO PEARLS <br /> SECTION FOR NEXT <br /> STEPS <br /> 20 <br />