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Naloxone 101: Learn How to Save a Life

Naloxone (Narcan, RiVive, Kloxxado) is a potentially life-saving medication that can reverse the effects of an opioid overdose. Opioids affect the same brain receptors that regulate breathing, and high dosages of opioids can severely depress a person’s breathing, potentially leading to respiratory failure and death. Naloxone stops the effects of these breath-regulating brain receptors.

Important Facts to Consider

Common signs of an opioid overdose include:

  • Small, “pinpoint pupils.”
  • Unconsciousness.
  • Slowed or stopped breathing.
  • Choking or gurgling sounds.
  • Limp body.
  • Cold and/or clammy skin.
  • Blue or purple fingernails, lips, or skin.

When naloxone is administered correctly and in time, a person suffering from an opioid overdose should begin breathing again. Naloxone is fast-acting and wears off after 30 to 90 minutes. Because certain opioids, such as fentanyl, may remain in the body longer than 90 minutes, overdose symptoms can return and require additional doses of naloxone. It’s important to call 911 in the event of an overdose, even if you have already administered naloxone to the person.

Using Naloxone

If someone shows any of these overdose signs, follow these basic instructions to assist the person’s breathing and correctly administer naloxone.

Check For Responsiveness

To assess whether or not the victim is coherent and/or responsive:

  • Call out their name loudly and shake them.
  • If no response, rub your knuckles hard against the person’s sternum to check their pain response.
  • If the person does not respond and breathing is very shallow or not at all, call 911 and begin rescue breathing immediately.

Rescue Breathing

To begin rescue breathing:

  • Tilt head back.
  • Seal your lips onto theirs.
  • Give 2 normal-sized breaths.
  • Give one breath every 5 seconds.
  • After you have performed a few rescue breaths, quickly locate and administer naloxone.

Giving the Medication

Now it’s time to administer the naloxone. The proper steps of administration will ultimately depend on the type of naloxone being used: injectable naloxone or nasal spray naloxone.

Let’s take a look at both forms and how they should be administered:

Injectable Naloxone

  • Use the 1-1.5 inch needle. (Typically available with the medication.)
  • Pry the orange top off the naloxone vial.
  • Draw 1cc of naloxone into the syringe.
  • Inject straight into a major muscle (shoulders, buttocks, thighs) at a 90-degree angle.
  • After injection, continue rescue breathing until they respond to the naloxone or first responders arrive.

Nasal Naloxone

  • Pry off yellow caps on the plastic delivery device (essentially a needleless syringe).
  • Pry off the red cap on the naloxone cartridge.
  • Gently screw the naloxone cartridge into the barrel of the syringe.
  • Tilt the head back and spray half of the naloxone (1cc) into one nostril. Spray the other half into the other nostril.
  • Continue rescue breathing until they respond or first responders arrive.

After Administering Naloxone

After you’ve given the correct dosage of naloxone, you’ll want to keep the following in mind:

  • If the victim does not respond within three to five minutes, give another dose of naloxone.
  • The victim won’t remember overdosing and may feel agitated, “dope sick” and will require an explanation.
  • Depending on the amount of opiates in their system and how long the naloxone lasts, the victim could re-overdose and should be closely monitored for at least an hour.
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