Naloxone, widely known as Narcan, rapidly reverses opioid overdose effects. This medication plays an important role in emergency situations by counteracting the life-threatening central nervous system and respiratory depression caused by opioids. Understanding proper administration methods is important, as its effectiveness in saving lives is linked to prompt and correct application.
Intranasal Delivery
Intranasal delivery of naloxone is a common and accessible method, using pre-packaged nasal spray devices like Narcan Nasal Spray. This needle-free approach simplifies administration for individuals without medical training, making it suitable for use by bystanders in community settings. Each Narcan Nasal Spray device contains a 4 mg dose of naloxone, delivered into one nostril.
To administer Narcan Nasal Spray, ensure the person is lying on their back with their head tilted back slightly. Hold the nasal spray device with your thumb on the bottom of the plunger and your first and middle fingers on either side of the nozzle. Insert the nozzle tip into one nostril until your fingers touch the bottom of the person’s nose. Then, firmly press the plunger to deliver the entire dose into the nostril. The person does not need to inhale to receive the dose.
Intramuscular Injection
Intramuscular injection offers another route for administering naloxone, often used by trained individuals or emergency responders, and in situations where a nasal spray might not be available. This method involves injecting naloxone directly into a muscle, using pre-filled syringes or auto-injectors. Common injection sites include the outer thigh or upper arm.
For intramuscular injection, devices like the ZIMHI auto-injector deliver a 5 mg dose of naloxone into the muscle. Other injectable forms may require drawing medication from vials into a syringe. When administering, select a muscle site like the outer thigh, and inject at a 90-degree angle. This can be done through clothing if necessary. Press the plunger to deliver the full dose, then remove the needle.
General Administration Guidelines
Regardless of the administration route, several universal guidelines are important to follow during an opioid overdose emergency. The first and important step is to call for emergency medical assistance, such as 911, immediately before or after administering the first dose of naloxone. This ensures professional medical care will arrive, as naloxone’s effects are temporary and the person may require further intervention.
After administering naloxone, position the person on their back, then move them into the recovery position if unresponsive but breathing. Monitor the person closely for a response, which occurs within 2 to 3 minutes. If there is no improvement or if the person relapses into respiratory depression, administer an additional dose of naloxone every 2 to 3 minutes, using a new device and alternating nostrils if using a nasal spray. Remain with the person and continue monitoring them until emergency medical personnel arrive.