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Index
Rapid Response Guide to Opioid Emergencies
Contents
Who should use this guide?
Disclaimer
1 Equipping yourself for opioid emergencies
A note about CPR training
Personal protective equipment (PPE)
Gloves
Eye protection
Respiratory protection
Protection for providing ventilation assistance
Hand sanitizer
Bottled water
Naloxone
Ready-made naloxone kits
Narcan nasal spray
Other intranasal (IN) injection kits
Intramuscular (IM) injection kits
Building your own naloxone kit
A note about mucosal atomization devices for IM injection systems
Why should you build your own naloxone kit?
Building a naloxone kit: police, corrections, and security officers
Storing and maintaining your rapid response equipment
What to do with used PPE and naloxone kits
References
2 How to recognize an opioid emergency
Signs and symptoms of opioid overdose
Commonly taught core triad of symptoms
Other symptoms
Other on-scene indicators of opioid overdose
What if you give naloxone to someone not in an opioid emergency?
References
3 Responding to opioid emergencies
Types of opioid emergencies
Opioid overdoses in monitored settings
Opioid emergency scenes in the community
Responding to an opioid emergency scene in the community: general procedure
Assess the scene
Call emergency medical services (EMS: 911)
Work with a buddy if possible
Cover your exposed skin and put on personal protective equipment (PPE)
Remove potential weapons on or near the person in crisis
Consider soaking in water any visible powder
Assist the person in crisis
Seek help if your health is at risk
Dispose of hazardous materials
Decontaminate
Seek mental-health support as needed
Responding to an opioid emergency scene in the community: law-enforcement, security, and corrections officers
Phases of an emergency
Self-care and buddy care
Steps for self-care administration of Narcan nasal spray
Steps for buddy care
Responding to an emergency scene in the community: health-care providers in emergency services
Responding to arrivals from an opioid emergency scene in the community
Pediatric opioid emergencies
Pediatric rapid response sequence
References
4 Complications in opioid emergencies
The person doesn’t respond to naloxone
What to do
The person has vomited
What to do
The person becomes hyperthermic after naloxone
What to do
The person becomes combative after naloxone
What to do
The person in opioid crisis is also injured
What to do
5 Mixed overdoses: opioids with other drugs
A mixed overdose scenario
How naloxone affects mixed overdoses
First-aid alerts for responding to mixed overdoses
Drugs commonly mixed with opioids
Alcohol
What is alcohol?
Signs and symptoms of alcohol use
Benzodiazepines
What are benzodiazepines?
Signs and symptoms of benzodiazepine use
Buprenorphine
What is buprenorphine?
Signs and symptoms of buprenorphine abuse
First-aid alerts for buprenorphine
Cannabis
What is cannabis?
Signs and symptoms of cannabis use
Cocaine and crack cocaine
What is cocaine?
Signs and symptoms of cocaine use
First-aid alerts for cocaine
Gamma-hydroxybutyrate (GHB)
What is GHB?
Signs and symptoms of GHB use
First-aid alerts for GHB
Ketamine
What is ketamine?
Signs and symptoms of ketamine use
First-aid alerts for ketamine
MDMA (ecstasy)
What is MDMA?
Signs and symptoms of MDMA use
First-aid alerts for MDMA
Methamphetamine
What is methamphetamine?
Signs and symptoms of methamphetamine use
First-aid alerts for methamphetamine
Phencyclidine (PCP)3
What is PCP?
Signs and symptoms of PCP use
First-aid alerts for PCP
Selective serotonin reuptake inhibitors (SSRIs)
What are SSRIs?
Signs and symptoms of serotonin syndrome
First-aid alerts for serotonin syndrome
References
6 Opioid emergency cases
Case 1: Heroin overdose
Rapid response
What happened?
Case 2: Unintentional overdose in an EMS procedural sedation
Rapid response
What happened?
Case 3: Unintentional overdose in a clinical setting
Rapid response
What happened?
Case 4: Overdose at a concert
Rapid response
What happened?
7 A primer on opioids, opioid use, and addiction
Opiates versus opioids
Semisynthetic opioids
Synthetic opioids
Medications that contain opiates and opioids
Comparing opioids
What do opioids do in the body?
Why do people become addicted to opioids?
Pain control and addiction
Stories of addiction and overdose
Addiction and withdrawal
Naloxone and withdrawal
The role of fentanyl and carfentanil in overdosing
References
Abbreviations
About the author
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