Is naloxone in your first aid kit?

619%

That’s how much on-the-job drug overdoses have increased since 2011, according to data compiled by the National Safety Council.

Is your workplace ready to respond to this type of emergency?

Including naloxone – an opioid overdose reversal medication – in your first aid kit and training workers on how to use it in an opioid overdose emergency “makes all the difference to an overdose victim’s survival,” the council says.

“It really is something that’s very simple to administer to someone,” NSC senior safety consultant Mike Ezzell said.

With Ezzell’s help, we’ve laid out the steps – and other information you should know.

Recognizing an overdose

Signs and symptoms of an opioid overdose can include:

• Unresponsiveness
• Slow, shallow or difficulty breathing
• Pinpoint pupils that don’t react to light
• Seizures
• Cold or clammy skin
• Blue/gray lips and skin
• Blue nail beds

NSC calls the first three of these symptoms the “opioid overdose triad,” as they’re traditionally the most common.

Although anyone who takes an opioid – including heroin, morphine and oxycodone – can experience an overdose, the Washington State Department of Health says it’s more likely to happen to people with a heart or lung condition or who:

• Take opioids with other drugs or alcohol.
• Take opioids that aren’t prescribed to them, or take more than the amount prescribed.
• Stop taking opioids for a while before starting to take them again.

Call 911 immediately if you suspect someone has overdosed.

“Because this truly is a serious medical situation, the first thing you want to do is call 911,” Ezzell said. “And then, hopefully, there’s someone else there you can send to get the first aid kit.”

Which means you need to make sure every employee is aware of where the naloxone is stored. Refill naloxone after doses are administered, as well as if the casing is damaged or the drug is expired or near its expiration date.

About naloxone

Last year, the Food and Drug Administration approved two naloxone nasal sprays for over-the-counter use: Narcan and RiVive.

Nasal sprays are the most common form of naloxone. The medication is also available by prescription as an auto-injector or nasal atomizer.

How does naloxone work? It temporarily reverses the effects of an opioid overdose by blocking opioid receptors in the body. This returns normal breathing to someone whose breathing has slowed or stopped because of the overdose. The medication pauses an overdose for 30-90 minutes but doesn’t remove opioids from the body.

The National Institute on Drug Abuse says people who have a physical dependence on opioids may experience withdrawal symptoms minutes after receiving naloxone.

Withdrawal symptoms include tremors, sweating, fast heartbeat, nausea, and/or behavioral changes such as confusion or anger. “While this is uncomfortable, it is usually not life-threatening,” NIDA emphasizes. “The risk of death for someone overdosing on opioids is worse than the risk of having a bad reaction to naloxone.”

Sometimes, a victim may exhibit signs of an opioid overdose but has used another drug. Naloxone doesn’t harm someone who hasn’t taken an opioid, experts note.

Administering naloxone

Begin giving naloxone as quickly as possible as you wait for emergency responders to arrive.

Place the nozzle in one nostril and press the plunger firmly, then check to see if the victim is breathing.

“Tap the person on the shoulder or gently try to move them and see if they respond or not,” Ezzell said.

If the victim is breathing, roll them onto their side and into the recovery position. If they aren’t breathing, start CPR and use an AED when available.

“If the person doesn’t respond to that first, initial dose of naloxone, if there is no improvement within two to three minutes, then you would give naloxone to them again,” Ezzell said.

By that time, you may have completed two to three cycles of CPR.

Use the other nostril when giving a second dose of naloxone. Stay with the victim and check for responsiveness and breathing until emergency responders arrive.

Remember: “Naloxone is not a replacement for seeking emergency medical assistance,” NSC says.

Some nasal sprays must be assembled before use. These devices typically require the user to deliver a half dose of naloxone into each nostril, so be sure to check the instructions before proceeding.

Additional steps from NSC:

• Take the device from its casing and remove the yellow applicator cap.
• Twist the nasal adapter on the tip of the applicator until tight.
• Remove the purple cap from the syringe.
• Insert the cap into the other side of the applicator and twist until tight.

If you’re using an auto-injector, remove the device from the casing and take off the safety cap. The dosage is injected into the victim’s muscle, usually in the outer thigh.

Press the device firmly against the person’s outer thigh. You’ll hear a click once the injection starts. How long you hold the injector in place varies by device. Read the instructions or listen to automated guidance from the device.

If naloxone is used, the casing is damaged, or the drug is expired or near its expiration date, remember to restock your first aid kit, Ezzell said.

Sometimes people are nervous about helping in an emergency. One final suggestion from Ezzell: Make sure employers and workers are familiar with the Good Samaritan laws in their state. These laws, which are in place in all 50 states and the District of Columbia, provide legal protection to anyone who gives reasonable assistance to people who are in peril or injured.