Reference protocol
💊 Naloxone
OPIOID OVERDOSE PROTOCOL
Version May 20, 2022
PROTOCOL — OPIOID OVERDOSE
LEVEL OF CONSCIOUSNESS
A
ALERT(Alert)
V
VERBAL(Verbal stimuli)
P
PAIN(Painful stimuli)
U
UNRESPONSIVE(Unresponsive)
Leave the victim
in the position of comfort
in the position of comfort
Do you suspect an
opioid overdose?
opioid overdose?
YES
Consider intranasal
Naloxone
Naloxone
NO
APPLY
MEDICAL PROTOCOL
MEDICAL PROTOCOL
Monitor constantly
and ensure they adequately
protect their airway
and ensure they adequately
protect their airway
Frequently reassess
vital signs (ABC)
vital signs (ABC)
Do you suspect an
opioid overdose?
opioid overdose?
YES
Consider intranasal
Naloxone
Naloxone
NO
APPLY
MEDICAL PROTOCOL
MEDICAL PROTOCOL
Monitor the victim
constantly (airway)
constantly (airway)
Frequently reassess
vital signs (ABC)
vital signs (ABC)
Is the victim still at 'P'
on the A-V-P-U scale?
on the A-V-P-U scale?
YES
Intranasal Naloxone
⏱ every 3 min
⏱ every 3 min
NO
If victim wakes up:
Recovery position
Recovery position
Monitor airway
constantly
constantly
Reassess vital
signs (ABC)
signs (ABC)
Prepare the Naloxone
according to label instructions
according to label instructions
1st dose Naloxone
intranasal route
Is the victim still
breathing?
breathing?
YES
Place in recovery position
Reassess vital
signs (ABC)
signs (ABC)
Repeat doses
⏱ / 3 min
⏱ / 3 min
If no longer breathing ↓
CPR
C — Compressions
A — Airway
B — Ventilations
NO
After 3 minutes
2nd dose Naloxone
intranasal
intranasal
Reassess vital
signs (ABC)
signs (ABC)
Turn the victim onto their back
Open the airway
(slight head tilt backward)
(slight head tilt backward)
If the victim is breathing
If not breathing
Place in
recovery position
recovery position
If overdose suspected:
1st dose Naloxone
intranasal
intranasal
Frequently reassess
vital signs (ABC)
vital signs (ABC)
2nd dose if no response
⏱ after 3 min
⏱ after 3 min
Apply CPR
C — Compressions
A — Airway
B — Ventilations
Naloxone per
manufacturer recommendations
manufacturer recommendations