Opioid Overdose

Opioid overdose is a devastating crisis affecting individuals worldwide. With opioids causing respiratory depression and potentially fatal consequences, swift intervention is crucial. One powerful tool in combating opioid overdose is naloxone, commonly known by the brand name Narcan.

In this, we will delve into the life-saving potential of naloxone as an opioid antagonist, understanding how it works, and its role in preventing opioid-related fatalities. We will also explore how naloxone is administered, including the simple skill that anyone can learn to save lives.

Understanding Opioid Overdose:

Opioids, including prescription painkillers and illicit substances like heroin, bind to opioid receptors in the brain and spinal cord, reducing pain and inducing feelings of relaxation and euphoria. However, an excessive dose of opioids can overwhelm the body, leading to slowed or shallow breathing, which can result in a dangerous lack of oxygen. This respiratory depression is the primary cause of death in opioid overdose cases.

In opioid overdose, the slowed or shallow breathing can progress to respiratory arrest, where breathing stops altogether. As the body is deprived of oxygen, the brain and other vital organs begin to suffer. The lack of oxygen can lead to a cascade of events, including cardiac arrest, where the heart stops beating effectively. It is important to recognize that opioid overdose fatalities are primarily caused by respiratory arrest, which then leads to cardiac arrest.

Administration of Naloxone

1. Check Scene Safety:

   Before approaching the individual, ensure that the scene is safe for both you and the person in distress. Look out for any potential hazards or risks.

2. Check Level of Consciousness:

   Assess the person's level of consciousness. Gently tap their shoulders and ask loudly, "Are you okay?" If there is no response or the person is unresponsive, proceed to the next steps.

3. Communicate:

   Clearly communicate your intentions to the person. Let them know that you are there to help and that you will be administering naloxone to reverse the effects of opioid overdose.

4. Personal Protective Equipment (PPE):

   Put on gloves to protect yourself from potential exposure to bodily fluids during the process.

5. Prep the Syringe:

   Take the naloxone syringe and carefully remove the cap. If necessary, snap or twist off the top of the ampule to access the medication. Attach the needle to the syringe securely.

6. Draw Up Naloxone:

   Hold the ampule upright and insert the needle into the ampule's opening. Slowly pull the plunger back, drawing up the appropriate amount of naloxone (as instructed by the manufacturer or medical professional).

7. Expel Extra Air:

   With the needle still in the ampule, gently tap the syringe to dislodge any air bubbles that may have formed. Slowly push the plunger up to expel the extra air until only naloxone remains in the syringe.

8. Lift Clothing and Insert Needle:

   Lift the person's clothing to expose an area of skin for injection, typically the upper arm, thigh, or buttocks. Hold the syringe like a dart and swiftly insert the needle into the muscle at a 90-degree angle.

9. Compress All Liquid:

   Push the plunger down fully, injecting all the naloxone into the muscle. Maintain pressure on the plunger for a few seconds to ensure all the medication has been administered.

10. Remove Needle and Dispose:

    Carefully remove the needle from the skin. Place the used needle and syringe into a sharps container or any designated puncture-proof container for safe disposal.

11. Monitor Level of Consciousness:

    Observe the person's level of consciousness and breathing. Stay with them and provide reassurance while waiting for emergency medical services (EMS) to arrive.

Remember, this tutorial serves as a general guide. It is essential to receive proper training on naloxone administration and follow the guidelines and instructions provided by healthcare professionals or local authorities.

Naloxone and CPR

Opioids depress the central nervous system, causing slowed or shallow breathing. If left untreated, this respiratory depression can progress to respiratory arrest, where breathing stops completely. When the body is deprived of oxygen, it can quickly lead to cardiac arrest, where the heart stops beating effectively.

In the event of a suspected opioid overdose, it is crucial to act swiftly. If you encounter someone who is not breathing and does not have a pulse, it is essential to initiate cardiopulmonary resuscitation (CPR) in conjunction with administering naloxone.

CPR involves a combination of chest compressions and rescue breaths, which aim to circulate oxygen-rich blood to the vital organs of the body. It helps to maintain a minimal level of oxygen supply until professional medical help arrives. CPR should be performed following the recommended guidelines and in accordance with any specific training you have received.

Naloxone is a vital component of overdose response because it rapidly reverses the effects of opioids and restores normal respiratory function. When administering naloxone during CPR, it can help counteract the respiratory depression caused by opioids, supporting the resuscitation efforts. By combining naloxone with CPR, you address both the respiratory and circulatory aspects of the overdose emergency, increasing the chances of successfully restoring the person's breathing and heartbeat.

In the event of a suspected opioid overdose where the individual does not have a device, such as a rescue facemask with a one-way valve, to protect yourself during rescue breaths, you can opt for compression-only CPR. Compression-only CPR involves performing continuous chest compressions without providing rescue breaths.

To perform compression-only CPR, follow these steps:

1. Ensure the person is lying on a firm surface.

2. Kneel beside the person's chest.

3. Place the heel of one hand on the center of the person's chest, between the nipples.

4. Place your other hand on top of the first hand, interlocking your fingers.

5. Keep your arms straight and position your shoulders directly above your hands.

6. Push hard and fast, compressing the chest at a rate of about 100-120 compressions per minute.

7. Allow the chest to fully recoil between compressions, but do not lift your hands off the chest.

Remember, in any medical emergency, including a suspected opioid overdose, it is essential to call 911 immediately. The emergency dispatcher can provide guidance and instructions tailored to the specific situation.

Remember, naloxone is not a substitute for seeking emergency medical assistance. Even if the person responds to naloxone and CPR, it is crucial to call emergency services right away. Prompt medical attention is necessary to provide comprehensive care and further stabilize the individual.

Training

Thank you for accompanying us on this two-part blog journey about naloxone. We hope that through this valuable information, you have gained the confidence and knowledge to respond effectively in opioid overdose emergencies. At Delta Emergency, we are committed to providing comprehensive training on naloxone administration, including recognizing signs and symptoms of opioid overdose, in our first aid and advanced first aid courses. Thank you for staying engaged, and together, let's make a positive impact by being prepared to respond in critical situations.