IN Naloxone protocol

Seizing child recieving IN treatmentTherapeutic Intranasal Drug Delivery

Needleless treatment options for medical problems

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Intranasal naloxone protocol for opiate overdoses:

Indications: For use on patients suspected of opiate overdose
Procedure:
  1. Assess ABC’s – Airway, Breathing, Circulation
  2. For pulseless patients, proceed to ACLS guidelines
  3. Apnea with pulse – Establish oral airway and begin bag ventilation with 100% oxygen
  4. Load syringe with 2 mg (2 ml) of naloxone and attach nasal atomizer
  5. Place atomizer within the nostril
  6. Briskly compress syringe to administer 1 ml of atomized spray.
  7. Remove and repeat in other nostril, so all 2 ml (2 mg) of medication are administered
  8. Continue ventilating patient as needed

If no arousal occurs after 5-10 minutes, proceed down standard unconscious protocol including injectable naloxone and secure airway if necessary.

Comment: Most "failures" of IN naloxone are due to being in a hurry to see the patient wake up. IN naloxone takes 3-5 minutes to begin working. The patients often just breath but do not come up crazy so do not always expect full arousal. (The goal is breathing)

Comment 2: IN naloxone is now being used at a BLS, law enforcement and layperson level with good success.