First Responder Naloxone Grant Webinar

Transcription

1 First Responder Naloxone Grant Webinar December 22, 2014 Sarah Ruiz, MSW, Project Manager Naloxone Pilot Program, Massachusetts Department of Public Health Dr. Alexander Walley, MD, MSc, Assistant Professor of Medicine at Boston University School of Medicine (BUSM)

2 Overdose Suspected Check Pulse No Pulse Pulse 1) 2 min of CPR, 5 Cycles 2) Administer Naloxone 3) Apply Defibrillator 4) Follow Defib. prompts 5) Continue CPR 1) Administer Naloxone 2) Rescue breathing 3) If no change after 3 5 min repeat naloxone 4) Rescue breathing until help arrives

3 Remember Four Rights for medication administration Massachusetts Office of Emergency Medical Services Minimum Standards for First Responder Training in First Aid, Epinephrine Auto-Injector and Naloxone Use AR Right Patient (opioid overdose) Right Medication (Naloxone-check for clarity) Right Date (check expiration) Right Dose (spray half (1ml) in each nostril)

4 Naloxone formulations Intranasal Auto-injector

5 Intranasal naloxone needs to be dispensed with the mucosal atomization device If there is nasal trauma or bleeding, do not administer naloxone Benefits of Intranasal Naloxone Nose is an easy access point Painless Intranasal Naloxone Eliminates risk of contaminated needle sticks and needle dispensing

6 Give Naloxone: Intranasal 1. Remove both yellow caps from the ends of the syringe 2. Twist the nasal atomizer onto the tip of the syringe 3. Remove the purple cap from the naloxone 4. Twist the naloxone on the other side of the syringe

7 Give Naloxone: Intranasal Push 1ml (1mg) of naloxone into each nostril Administer the entire contents of the 2ml syringe with approximately one half (1ml) administered in each nostril Administering one half in each nostril maximizes absorption

8 Auto-injector Naloxone Each auto-injector contains only 1 dose Inject into muscle or skin of the outer thigh Can be injected through clothing if needed Device injects intramuscularly or subcutaneously, delivers the naloxone, and retracts the needle fully into its housing Needle not visible before, during, or after

9 Auto-injector Naloxone Practice with the Trainer to make sure you are able to safely use the auto-injector in an emergency The Trainer does not contain a needle or medicine It can be reused to practice your injection The red safety guard can be removed and replaced on the Trainer

10 Give Naloxone: Auto-injector

11 Give Naloxone: Auto-injector

12 Give Naloxone: Auto-injector

13 Give Naloxone: Auto-injector

14 How does a person respond to Naloxone? Scenarios: 1. Gradually improves breathing and becomes responsive within 3 5 minutes 2. Immediately improves breathing, responsive, and is in withdrawal 3. Starts breathing within 3 5 minutes but remains unresponsive 4. Does not respond to first dose and naloxone must be repeated in 3 5 minutes (keep rescue breathing)

15 After Administering Naloxone Continue rescue breathing with 1 breath every 5 seconds until emergency responders arrive After 3-5 minutes, if the patient is still unresponsive with slow or no breathing, administer another dose of naloxone

16 If victim is breathing, but unresponsive place in recovery position

17 Naloxone Storage Intranasal: Storage between 59 degrees to 86 degrees. Avoid extremes in temperatures for long periods of time Replace every 6-12 months, before expiration date Auto-injector: 59 F to 77 F (15 C to 25 C) Temperature excursions are permitted between 39 F and 104 F Keep in outer case until needed If solution through viewing window is discolored, cloudy, then replace Replace before expiration date

18 First Responder Naloxone Programs Lessons Learned Ensure First Responders perform rescue breathing and wait 3-5 minutes between doses of naloxone Do not administer multiple doses without a pause Practice ambu-bag skills Reinforce that the goal is to restore breathing not full alertness Be sure First Responders follow assessment protocol not every unconscious patient is in an opioid overdose Integrate overdose response and naloxone into annual retraining

19 Grant Program When paperwork is finalized the first check will be issued In the April 1 st and July 30 th reports each Department will report on activities and the City/Town will report on expenditures Reports must be signed by an authorized signatory Following April 1 st reports the second check will be issued. Contact us with any questions related to authorized expenditures.

20 Evzio Auto-Injector Before auto-injectors can be delivered Departments must have: an MOA with a Medical Director AND a Massachusetts Controlled Substance Registration (mail original form to 99 Chauncy St) Make sure DPH has correct contact person and delivery address for auto-injectors

21 Data Collection Data forms must be submitted each time first responder naloxone is used by a grantee department The Data Collection form will be ed to each Department shortly Data Collection webinar is scheduled for Monday February 2, 2015 at 2pm to go over the form and instructions in detail

22 Next Steps For training or technical assistance, contact Gary Langis, technical assistance provider for MassTAPP at or Online resources: Evaluation: Webinar recording and PPT Data Collection Webinar, February 2, 2:00 3:00 EST