Opioid Overdose
What are some examples of opioids?
Heroin, fentanyl, codeine, morphine, percocet, etc
What's typically more dangerous, prescription or non-prescription opioids?
Non-prescription
What is the generic name for Narcan?
Naloxone
What is the first step?
Survey the area - keep yourself safe!
How should you position someone before using Narcan?
Lay them on their back
What does NPA stand for?
Nasopharyngeal airway
What makes opioids so dangerous?
Addictive, strong, suppress breathing
Yes! Especially if prescribed a high dose
Where is Narcan administered?
What should you look for in the area?
Drug paraphernalia, safety
What is the first step?
Remove Narcan from package, check instructions
How many breaths should you deliver per minute?
1 breath every 5-6 seconds of ~10-12 breaths/min
What is the most common drug to overdose on?
Fentanyl
How can you avoid overdosing on prescription opioids?
Take exactly as directed
How long does Narcan take to start working?
2 minutes
What can you do to try to wake them up?
Shake the person, shout, sternum rub, trap squeeze
Where do you put the Narcan?
How do you use an NPA?
Measure, lubricate, insert bevel towards septum
What are signs of someone leading up to overdose?
What age is at higher risk of overdose?
Older, over 65 years old
How long do the effects of Narcan last?
30-90 minutes
What is the first concern for the overdosing person?
Airway/breathing
No, it is ready right out of the package
What method do we use to ensure a good seal while using the BVM?
EC method
What is their breathing like?
Slow, shallow, potentially apneic
Combining opioids with other substances increases or decreases risk?
Increases! Especially benzos, antihistamines, and alcohol
Can you give more than one dose of Narcan?
Yes, but you should wait 2-3 minutes for a response
How can you protect their airway?
Head tilt/chin lift
Jaw thrust
Suction
How do you administer the Narcan?
Press the plunger down (firmly)
How do you know you are getting adequate ventilations while using the BVM?
Chest rise/fall
ETCO2
What do their eyes look like?
Overdose more or less likely when restarting use?
More likely after loss of tolerance (detox, prison)
Where can we find Narcan in the ambulance?
Orange box, on the wall, more..?
How do you do support their respirations?
Open airway, use nasal adjuncts as necessary, use BVM to provide adequate ventilations
Can you give more than one dose of Narcan?
Yes! Wait 2-3 minutes between doses
35-45mmHg
What are other visible signs?
Blue fingertips/lips (lighter skin tones), gray or ashen fingertips/lips (darker skin tones)
Diaphoresis
What types of medical conditions affect overdose risk?
Kidney, liver, and lung diseases
How does Narcan work?
Reverses the overdose by binding to the same receptors in the brain, kicking out the opioid
What can you do beyond helping with breathing?
Narcan!
Where would you give injectable naloxone?
Deltoid, vastus lateralis, ventrogluteal
Why is end tidal CO2 the gold standard for determining breathing quality?
Provides information about how well a person's body is carrying and exhaling CO2. You can see depth, rate, and regularity.