Download ArticleDownload ArticleThis article was medically reviewed by Jennifer Boidy, RN. Jennifer Boidy is a Registered Nurse based in Baltimore, Maryland. In addition to her nursing career, she also works as a Healthcare Content Strategist & Writer, helping businesses and non-profits market their products and services to healthcare provider organizations, pharmaceutical companies, and other healthcare services vendors. Jennifer’s areas of expertise include pharmaceuticals & life sciences, health technology, medical devices & diagnostics, health insurance & managed care, and healthcare services & facilities. Her certification as a Registered Nurse was issued by the Maryland Board of Nursing. She graduated from the University of Maryland with a BS in Marketing and Finance. She received her Associate of Science in Nursing from Carroll Community College in 2012.
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Watching someone you care about struggle with addiction can be devastating, but knowing how to administer Narcan may save their life and can help you feel more in control. The misuse of legal or illegal opiate (narcotic) drugs can easily lead to taking an excessive amount, which causes an overdose that makes the victim stop breathing. However, Narcan (naloxone, also branded Evzio) can often reverse opiate overdose.[1] Now that the public has access to easily administered forms of naloxone, the fight against addiction may get easier. When trying to help, it's important to monitor the victim closely, call for emergency services, give CPR if needed, and administer the Narcan effectively whether it's a nasal spray or injection.
Steps
Check for signs of an overdose. Before you administer Narcan, make sure to check the person for symptoms of an overdose. Symptoms may include:[2]- Slow or shallow breathing.
- Gasping noises while sleeping or snoring in an unusual way.
- Skin that is pale or bluish.
- A slow heartbeat.
- Low blood pressure.
- Unresponsive and will not wake up.
Call emergency services. Call 911 or emergency services in your country right away! It is important to ensure that help is on the way before you do anything.[3]Advertisement
Check the person's airway and administer rescue breaths. Check the person's mouth and throat to ensure that there is nothing blocking their airways. Place one hand on the person's chin, tilt up their head slightly, and pinch their nose closed. Then, make a seal around their mouth with your mouth, breathe in and blow the breath into their mouth. You should see their chest rise as you deliver the rescue breath and then fall as you remove your mouth from their mouth.[4]- Deliver one breath every five seconds.
Remove the yellow caps from the syringe. Prepare the nasal syringe immediately after giving several rescue breaths (if necessary). Pry or pull off the yellow caps. There are usually two – one at each end of the syringe.- A syringe is not a needle, it's a plastic device that holds the needle – or in this case, what the Narcan screws onto.
- You can find Narcan through the getnaloxonenow.org website.
Take the red cap off the Narcan. The tube of Narcan (also labeled under the generic name naloxone) may have a red cap. Pry this off and discard it.
Put the three pieces together. Grip the clear plastic wings of the nasal atomizer (the cone-shaped applicator), and insert it onto the syringe. Gently screw the Narcan container onto the barrel of the syringe.- Do not prime or test the spray. It is single-use and can't be reused.[5]
- Some Narcan nasal sprays come in single-use, pre-assembled packages. They contain two needle-free devices, one to use in each nostril.
Administer the Narcan half in each nostril. Lay the victim on their back and tilt their head back. Place the white cone applicator into one nostril of the victim's nose. Give a short, hard push onto the end of the capsule to spray the Narcan. Deliver half of the container (1cc).- Repeat the process immediately in the victim's other nostril.
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Remove the outer case. Injectable Narcan, labeled as EVZIO, comes in a case. Take the device out of the case, but do not remove the red safety guard until you are ready to inject the medicine.
Take off the red safety guard. When you are ready to inject, remove the red safety guard. You might need to pull the red safety guard a little hard to get it off. Do not touch the black area of the EZVIO after you get the red safety tab off. This is where the needle is located.
Place the black end of the device against the outer thigh and inject. Place the black area of the device on the middle of the person's outer thigh so that it is right over the muscle. To inject the medicine, hold the device firmly against the person's thigh for five seconds. You do not need to remove the person's clothing to do this.- You will hear a click and hiss sound as the device automatically injects the medicine into the person's thigh. This is normal and means the device is working.
- The needle will retract into the device after the injection is complete.
Call emergency services. Make sure to call 911 (or emergency services in your country) immediately after giving the injection or have someone call for help while you are giving the injection.
Administer Narcan only if the victim meets the criteria. Only administer Narcan if the victim exhibits the following signs of overdose:- They are unconscious, unresponsive, and you cannot wake them
- They have pinpoint (constricted) pupils
- Their breathing is slow and shallow, breathing fewer than 8 times per minute
Provide supportive care until help arrives. When you find a loved one unconscious, yell and rub your knuckles on the center of their breastbone to try to wake them. If they wake up, they do not need Narcan.[6] If not, call emergency services immediately and tell them that someone may have overdosed. Before giving Narcan, see if the victim needs CPR - this may save their life! Follow these guidelines:- Count their breaths: Listening at their mouth while watching to see whether their chest is rising and falling for 5-10 seconds.[7] If they are not breathing or are breathing fewer than 8 times per minute, give them a few rescue breaths before administering Narcan.
- Check for a pulse for 30 seconds by placing your middle and forefingers on the victim's neck just off to the side a little, under the jaw line. If they don't have a pulse, start CPR chest compressions.
Be sure the victim gets to the hospital. Emergency services should immediately take the victim to intensive care for monitoring. If you are unable to access emergency services, get the person to the hospital as soon as they can breathe on their own. They need medical care even if their overdose is reversed by Narcan.
Encourage the victim not to use again that day. Narcan can cause symptoms of withdrawal, making the victim want to use their drug again. Doing so can cause another overdose. These cravings may be difficult for both of you to deal with. Try to support the victim emotionally, and encourage them not to use drugs again that day.
Store the Narcan appropriately. Store any Narcan you have tightly closed in its original container and out of the reach of children.[8] Store it at room temperature in a dark place and avoid keeping it anywhere that gets hot or moist, such as in the bathroom. Never freeze the medicine either.[9] Dispose of the Narcan and get a new one if the red safety guard has been removed, it is expired, it looks cloudy or you can see particles floating in it.- Keep it safely out of reach of children. Do not let anyone else use your medication.
Know the victim's drug of abuse. If a loved one uses illegal drugs or takes prescription medications inappropriately, try to find out what they take. Ask them outright and let them know you're concerned about their safety. Narcan can reverse the effects of opiate drugs such as:- Heroin
- Prescription pain medicine like fentanyl, morphine, methadone, buprenorphine, hydrocodone, and oxycodone
- Some common brand name medications such as Percocet, OxyContin, Vicodin, Percodan, Tylox, and Demerol
Get Narcan from a doctor. If you or a loved one suffer from opiate addiction, talk to your doctor about getting Narcan to keep on hand. You may be able to obtain liquid Narcan that can be injected into a vein, muscle, or under the skin, or a nasal spray. You need a prescription to get Narcan in some states but not others.- Automatic injection devices (Evzio) are sometimes available. These have voice guidance that can direct you or another on how to use the device. Use it once then throw it away. This is the BEST OPTION if you do not have medical training.
- You will probably not be able to administer Narcan to yourself if you are overdosing. Friends, family, and loved ones should know how to use the Narcan and where to find it.
Do a quick scan for signs of opiate overdose. You may not always know what drug someone has overdosed on, or if they've used drugs at all. Don't waste time, but look very quickly for some signs that the victim may have overdosed on opiates. Scan quickly for prescription drug bottles lying around, a morphine or fentanyl patch on their body (remove it!) or visible drug paraphernalia like syringes, spoons, and tourniquets.
Expert Q&A
Tips
- If you know someone struggling with opiate addiction, alert them to community and national services such as the Harm Reduction Coalition and other recovery resources.[10]Thanks
- To give rescue breaths, tilt the victim's head back slightly and lift their chin to open the airway. Pinch their nose closed with one hand. Put your mouth over the victim's mouth to make a seal and blow into their mouth. Watch to be sure their chest rises when you give a breath – if not, exhale more forcefully.[11]Thanks
- Check the expiration date of Narcan you keep, and replace it if it expires.Thanks
References
- ↑ http://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-opioid-overdose-drug/
- ↑ http://content.govdelivery.com/attachments/MDMBP/2014/10/30/file_attachments/337074/Patient%2BInstructions%2Bfor%2BIntranasal%2BNaloxone%2BAdministration.pdf
- ↑ http://content.govdelivery.com/attachments/MDMBP/2014/10/30/file_attachments/337074/Patient%2BInstructions%2Bfor%2BIntranasal%2BNaloxone%2BAdministration.pdf
- ↑ http://content.govdelivery.com/attachments/MDMBP/2014/10/30/file_attachments/337074/Patient%2BInstructions%2Bfor%2BIntranasal%2BNaloxone%2BAdministration.pdf
- ↑ http://www.mayoclinic.org/drugs-supplements/naloxone-nasal-route/proper-use/drg-20165181
- ↑ https://medlineplus.gov/druginfo/meds/a612022.html
- ↑ http://www.theadventuremedic.com/features/avalanche-safety-medical-management-avalanche-victims/
- ↑ https://medlineplus.gov/druginfo/meds/a616003.html#storage-conditions
- ↑ https://medlineplus.gov/druginfo/meds/a612022.html
About This Article
If you notice signs that someone is having an overdose, such as slow or shallow breathing, gasping noises, pale or blueish skin, or unresponsiveness, call emergency services before you administer Narcan. While you’re waiting for help, check the person’s airway to make sure nothing is restricting their breathing. Then, administer rescue breaths by pinching their nose closed, making a seal around their mouth with your lips, and blowing air into their mouth. If they don’t wake up after a few breaths, take out your Narcan syringe. For an intranasal syringe, take off the yellow and red caps and put the 3 pieces together to form the syringe. Administer half of the Narcan into each nostril by pushing the plunger. For an intravenous syringe, remove the red safety guard and place the black area of the device onto the middle of the person’s outer thigh until you hear a click and hiss as the device automatically injects its medicine. For more tips from our Medical co-author, including how to care for an overdose victim after administering Narcan, read on.
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