7-348 - Nalaxone (Narcan) Administration and Maintenance

Opiate overdose fatalities may be preventable if interventions are introduced quickly. The purpose of this policy is to establish broad guidelines and regulations governing the use of Naloxone by trained personnel within the MPD. The objective is to render aid and ultimately reduce injuries and fatalities associated with opioid-involved overdoses.

Intranasal: A method of medication administration where medication is sprayed into the nose and is absorbed by the mucus membranes in the nose.

Naloxone: A prescription medication that can be used to reverse the effects of an opioid overdose. Specifically, Naloxone is an opioid antagonist. It binds to chemical receptors in the body; slowing or stopping the effects of opioids. Naloxone is the generic name whereas Narcan is the trade name for this drug.

Naloxone kit: This overdose kit includes (1) Naloxone pre-filled Luer-Lock (needleless) syringe containing 2mg/2ml, (1) mucosal atomization device, and (1) storage bag.

Opioid: A medication or drug that is derived from the opium poppy or that mimics the effect of an opiate. Opiate drugs are narcotic sedatives that depress activity of the central nervous system; these will reduce pain, induce sleep, and in an overdose will cause people to stop breathing. Commonly called, but not limited to, Heroin, Morphine, Dilaudid, Oxycodone, Methadone, Hydrocodone, Fentanyl, and Codeine.

1. Department-issued Naloxone shall only be administered by authorized personnel who have completed the training required by this policy.
2. Department-issued Naloxone shall only be administered according to the procedures outlined in this policy.
3. Employees that have received Naloxone Training and have been issued a personal Naloxone Kit shall carry the Naloxone Kit on their person or have it readily accessible for use, at all times while working in an MPD Uniform.
4. If an officer does not have Naloxone, MN Statute § 604A.04 provides immunity for a person who acts in good faith in administering an opiate antagonist to another person whom the person believes in good faith to be suffering from a drug overdose.
5. All administration of Naloxone shall be documented as outlined in this policy.
6. Naloxone kits shall be carried in a manner consistent with proper storage guidelines for temperature and sun exposure, as outlined in training.

1. The kit shall be inspected for damage or expiration when removing from storage.
2. Expired, damaged and missing kits shall be reported to an immediate supervisor as soon as possible.

Department-issued Naloxone Administration

1. Naloxone shall only be administered by intranasal route.

Trained personnel administering Naloxone shall adhere to the following procedures:

2. Request standard EMS response if not already in progress.
3. Maintain scene safety and personal universal precautions.
4. Perform victim assessment to determine unresponsiveness, absence of breathing, pinpoint pupils, and/or no pulse.
5. Provide basic life support practices as needed.
6. Perform situation assessment to determine whether it is more likely than not the victim’s condition is an opiate overdose.

If it is more like than not the victim’s condition is an opiate overdose:

7. Administer one half of the Naloxone capsule (1 mg) to one nostril as trained.
8. If the patient has no improvement in breathing or has not regained consciousness in 2-5 minutes, a 2nd dose of Naloxone may be administered to the other nostril. If the victim’s condition markedly improves prior to the administration of the 2nd mg of Naloxone, the 2nd mg does not need to be administered.
9. Continue to provide basic life support care to the victim.
10. Update responding Paramedics of:

1. Amount of Naloxone given, and
2. Any change in victim’s condition.

11. Obtain a refill for the Naloxone kit as soon as possible.

Documentation

Any personnel who administered Naloxone shall complete the following documentation:

1. Complete an Offense/Incident report titled “OD,” including the EMS run number and hospital to which the individual was transported.

1. Describe efforts to revive the overdosed individual (e.g., rescue breathing, chest compressions, administered Naloxone, other).
2. Amount of Naloxone administered.
3. Change in individual after the administration of the Naloxone (e.g. regained consciousness or failed to regain consciousness).
4. If the individual regained consciousness, the individual’s behavioral reaction (e.g. aggressive, yelling, calm, confused, or seemed normal).

2. Fill out and submit the Naloxone Deployment Reporting Form to the Naloxone Program Administrator prior to the end of your shift.

Supervisor Responsibilities

1. Respond to calls when Naloxone is being administered, whenever possible.
2. Ensure proper protocols are being followed.
3. Review reports documenting the use of Naloxone.
4. Ensure subordinates attend Naloxone training when required and appropriate.
5. Submit a memorandum to the Naloxone Program Administrator after being notified by a subordinate of any used, expired, damaged or missing Naloxone kits.

Naloxone Program Administrator Responsibilities

Training

1. Coordinate and implement initial Naloxone training for personnel, as well as re-certification training as required by policy.
2. Ensure all personnel have successfully completed Naloxone training prior to treating individuals with Department-issued Naloxone.
3. Maintain training records of personnel allowed to carry and administer Department-issued Naloxone.

Naloxone kit supply

1. Ensure an adequate, non-expired supply of Naloxone is available for MPD use.
2. Replace Naloxone kits that are damaged, unusable, expired or deployed after being made aware of issues with the kit supply or via a memorandum from a supervisor.

Administrative Records

1. Maintain records to comply with the requirements of reporting the receipt and administration of Naloxone in accordance with the State of MN and MPD Medical Director.
2. Maintain administrative records regarding departmental use of Naloxone and disseminating these records to the appropriate authorities.

Training and Education

1. Those authorized to administer Department-issued Naloxone shall complete an initial training course prior to receiving and administering Naloxone. This education will include both didactic and practical formats or as required by the Medical Director.
2. Recertification shall be attended every two years as required by the Medical Director.

Expired Naloxone kits

Expired Naloxone will be:

1. Maintained by the department for use in training; or
2. Properly documented and disposed of by the Leadership and Organizational Development Division.