First responders gain tool to fight opiate overdoses

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(Posted May 20, 2014)

Messenger photos by Kristy Zurbrick Robert Olwin, chief of the Madison County Emergency Medical District, demonstrates how to administer naloxone, a drug that combats opiate overdoses.
Messenger photos by Kristy Zurbrick
Robert Olwin, chief of the Madison County Emergency Medical District, demonstrates how to administer naloxone, a drug that combats opiate overdoses(Posted May 20, 2014)

By Kristy Zurbrick, Madison Editor

Local first responders, including police officers, sheriff’s deputies and fire fighters, are learning how to administer naloxone, a potentially life-saving drug that can quickly reverse an opiate overdose.

The trainings come on the heels of House Bill 170, a new Ohio law that allows all first responders, not just advanced paramedics, to carry and administer naloxone, commonly known by its brand name, Narcan.

Robert Olwin, chief of the Madison County Emergency Medical District, conducted the first local training May 8. In attendance were officers from the London Police Department. Additional trainings are planned for departments throughout the county.

“This will really help us. Madison County is so spread out. It takes 15 to 18 minutes for the squad to get to some parts of the county, like Resaca. Now, a police officer or deputy who is a lot closer and gets to a call first can administer the drug sooner,” Olwin said.

Naloxone treats breathing problems caused by opioids by blocking opioid receptors in the brain and nervous system. The drug is effective on overdoses involving prescribed opioids, such as morphine and oxycodone, and illegal opioids, including opium and heroin.

Local first responders will carry naloxone in liquid form in pre-loaded syringes to be administered into the nostrils. The syringes are outfitted with a mucosal atomization device (MAD) on the tip to prevent damage to the nasal cavity and maximize delivery of the drug to the patient.

When a first responder responds to an overdose call and suspects heroin or another opiate is involved, they don’t immediately administer naloxone. They must first check the patient’s breathing. If the patient is unresponsive but breathing at least six to eight times per minute, they monitor the patient and wait until the EMS arrives. If the patient is not breathing adequately, the responder adjusts the patient’s head and neck position to open the airway. If the breathing doesn’t improve, the responder considers the use of naloxone and supporting respirations with rescue breathing.

In the protocol for the Madison County Sheriff’s Office and London Police Department, Olwin recommends administering 0.5 mg of Narcan in each nostril, with repeat doses if needed. If a patient is suffering from an opiate overdose, the medication will bring them out of it. (Responders must avoid rapid administration of the medication, which could cause serious complications.)

Patients can “wake up” with opioid withdrawal symptoms, including extreme agitation, vomiting and seizures. Olwin advises moving sharp and heavy objects out of reach before administering the drug. The use of restraints also is an option.

“Narcan only works on opiates. If it’s given to someone who isn’t on opiates, you can’t harm them,” Olwin said.

Every department that supplies officers with naloxone must have a procedure in place for tracking and accounting for the medication. Each officer will be assigned a kit with their name on it. Once a month, they must record the expiration date and tag number of unused medication. If they use the medication, they must report it to the appropriate authority. For London police officers and Madison County Sheriff’s deputies, that authority is the Madison County Emergency Medical District.

By law, non-medical first responders are not required to administer naloxone.

“They’re not legally obligated to use it. They’re not in trouble if they don’t, but it’s another tool in their car that may save a life,” Olwin said.

After House Bill 170 passed in the House last fall, Lorraine County, Ohio, conducted a pilot program for the administration of naloxone by local first responders. In a six-month period, the program saved 15 lives.

In Madison County, the Mental Health Recovery Board of Clark, Greene and Madison Counties provided funding to purchase naloxone, syringes and storage containers for area first responders.

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