Transcript Naloxone Formulation Update 2014

Naloxone formulation update
October 2014
Overdose Suspected
Check Pulse
No Pulse
Pulse
1) 2 min of CPR, 5 Cycles
1) Administer Naloxone
2) Administer Naloxone
2) Rescue breathing
3) Apply Defibrillator
3) If no change after 3 – 5
min repeat naloxone
4) Follow Defib. prompts
5) Continue CPR
4) Rescue breathing until
help arrives
Remember “Four Rights”
for medication administration
Massachusetts Office of Emergency Medical Services Minimum Standards for
First Responder Training in First Aid, Epinephrine Auto-Injector and Naloxone
Use AR-2-100
• Right Patient (opioid overdose)
• Right Medication (Naloxone-check for clarity)
• Right Date (check expiration)
• Right Dose (spray half (1ml) in each nostril)
Naloxone formulations
Intranasal
Auto-injector
Intranasal Naloxone
• Intranasal naloxone needs to be dispensed with the
mucosal atomization device
• If there is nasal trauma or bleeding, do not administer
naloxone
Benefits of Intranasal Naloxone
• Nose is an easy access point
• Painless
• Eliminates risk of contaminated needle sticks and needle
dispensing
Give Naloxone: Intranasal
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Remove both yellow caps from the ends of the syringe
Twist the nasal atomizer onto the tip of the syringe
Remove the purple cap from the naloxone
Twist the naloxone on the other side of the syringe
Give Naloxone: Intranasal
• Push 1ml (1mg) of naloxone into each nostril
• Administer the entire contents of the 2ml syringe with
approximately one half (1ml) administered in each
nostril
• Administering one half in each nostril maximizes
absorption
Auto-injector Naloxone
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Each auto-injector contains only 1 dose
Inject into muscle or skin of the outer thigh
Can be injected through clothing if needed
Device injects intramuscularly or
subcutaneously, delivers the naloxone, and
retracts the needle fully into its housing
• Needle not visible before, during, or after
Auto-injector Naloxone
• Practice with the Trainer to make sure you are able to safely use
the auto-injector in an emergency
• The Trainer does not contain a needle or medicine
• It can be reused to practice your injection
• The red safety guard can be removed and replaced on the
Trainer
Give Naloxone: Auto-injector
Give Naloxone: Auto-injector
Give Naloxone: Auto-injector
Give Naloxone: Auto-injector
How does a person respond to
Naloxone?
Scenarios:
1. Gradually improves breathing and becomes responsive within 3
– 5 minutes
2. Immediately improves breathing, responsive, and is in
withdrawal
3. Starts breathing within 3 – 5 minutes but remains unresponsive
4. Does not respond to first dose and naloxone must be repeated
in 3 – 5 minutes (keep rescue breathing)
After Administering Naloxone
• Continue rescue breathing with 1 breath every
5 seconds until emergency responders arrive
• After 3-5 minutes, if the patient is still
unresponsive with slow or no breathing,
administer another dose of naloxone
If victim is breathing, but unresponsive
place in recovery position
Naloxone Storage
• Intranasal: Storage between 59 degrees to 86 degrees.
– Avoid extremes in temperatures for long periods of time
– Replace every 6-12 months, before expiration date
• Auto-injector: 59°F to 77°F (15°C to 25°C)
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Temperature excursions are permitted between 39°F and 104°F
Keep in outer case until needed
If solution through viewing window is discolored, cloudy, then replace
Replace before expiration date