Naloxone use Objectives In this slide set, you will learn: What naloxone (Narcan) is How it works...

EMERGENCY MEDICAL RESPONDERS ANDLAW ENFORCEMENT

Naloxone use

Objectives

In this slide set, you will learn:What naloxone (Narcan) isHow it works when administered to a person

who has overdosed on opioidsHow to recognize the signs of a opioid

overdoseWhen to give naloxone to a person who has

overdosed on opioids

Statistics

Death resulting from heroin overdose has double in the past two years

Death resulting from overdose of prescription pain killers has quadrupled in the past 10 years

Nearly 8,000 people a year die from heroin overdose and 16,000 from overdose of prescription pain killers

Definition

Opioid substances are chemicals that interact with a specific receptor in the brain and cause an expected effect of respiratory depression, sleepiness and small pupils among other things

Examples include heroin, morphine, codeine, dilaudid, oxycodone

Why do people die?1. Too much heroin or other

opioids causes people to become very sleepy.

2. Opioids cause a reduction in breathing rate by acting directly on the brain.

3. This leads to low oxygen levels which causes damage to the heart and brain.

4. Eventually, the heart slows down and stops

Steve’s Law

In 2014, the Minnesota State Legislature passed “Steve’s Law” allowing firefighters and other first responders to administer naloxone to a person who is exhibiting the signs of an opioid overdose.

The bill also allows non-medical, trained lay-persons to administer the medication in the right setting

Authorization

EMR or law enforcement groups who want to provide naloxone will need to get authorization from a licensed physician, physician assistant or advanced practice nurse.

An EMR group must be registered with the state of Minnesota.

Naloxone Naloxone is a

medication available in all hospitals and most ambulances.

It acts in the brain to immediately reverse the effects of the opioid in the person’s system

It last about 45 minutes before it is cleared from the body

Side effects

Naloxone has no side effects and very few people have shown an allergy to the medication

The person could develop vomiting, sweating or shortness of breath once the medication wakes them up These are essentially symptoms of

withdrawal from the opioid and are not unexpected

What does an overdose look like? Signs and symptoms of an opioid

overdoseblue lips and fingernails, a slow pulsevery small pupilsabsent or very slow breathinginability to be woken up.

Act Fast

When you find someone who you think as overdosed, look for the tell tale signs.Are they sleepy and cannot be woken up?Is there breathing very slow or absent?Are their pupils very small?

Treating the patient

Ensure the scene is safe Assess ABCs and treat any immediate

life threats Provide supplemental oxygen as needed If inadequate respiratory effort

open airwayattempt to place an oral airway support the patient’s breathing with

ventilations using a pocket mask or BVM

Administer Naloxone

If the patient has inadequate breathing as well as other signs of opioid overdose, prepare to give Naloxone.The medication can be given intranasally,

intramuscularly or intravenously.Most EMR groups will use the nasal version

while laypersons will likely use the intramuscular version of the medication.

The EVZIO auto-injector of naloxone

Think combination EPI-Pen and AED

Available by prescription

Cost is high, around $500-$700.

The SRHF has received some as a donation

EVZIO - Use The device has

audible instructions that start when the safety cap is removed

Follow the very simple directions

EVZIO

The EVZIO naloxone is no different that other sources.

It is a 0.4mg dose, just like what is given in the typical IM dose.

Use the same injection locations such as thigh or upper arm

The device is ONE-USE ONLY.

Using Naloxone intranasally

Why the nose The nose is a

perfect place to absorb medication

Nasal mucosa gets more blood flow per unit of area than the liver or brain

Many forms of Nalxone

1 mg in 1 ml of fluid 0.4 mg in 1 ml of fluid

Best used for nasal

Best used for intramuscular

Higher concentrated version

Recommendations are to use no more than 0.5 to 1 ml of fluid in a nasal administration since the absorption is worse if more fluid is put into the nose

Nasal Administration

Ensure the persons nose is relatively clear

Attach the medication vial to the syringe Attach the atomizer to the syringe Place the atomizer snuggly against the

nostril opening. Briskly push the medication vial into the

syringe, dispensing ½ of the medication

Nasal Administration

Place the atomizer snuggly against the opening of the other nostril

Briskly push the medication vial into the syringe and dispense the second half of the medication

Continue rescue breaths and recheck the person’s alertness in 2 minutes

Administer a second dose of naloxone if the person is not breathing.

After care

Prepare patient for transport The patient should be transported to an

Emergency Department due the relative short-term effects of Naloxone.

Save a life

You can not harm someone by giving them naloxone

In many cases, you will safe a life.

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