Opioid Overdose Rescuewith Naloxone Auto-injector KitPatient Guide
VA PBM Academic Detailing ServiceReal Provider ResourcesReal Patient ResultsYour Partner in Enhancing Veteran Health OutcomesVideo demonstration @ “How to Use the VA Auto-Injector Naloxone Kit”https://youtu.be/-DQBCnrAPBY
Kit Instructions Keep two auto-injectors with you at all times Store auto-injectors at room temperature, away from light Keep auto-injectors out of the heat or cold—e.g., do not storein your car—otherwise naloxone will lose its effectiveness If you use an auto-injector or your auto-injectorsexpire, contact your provider as soon as possible fora replacement Contact your pharmacy about the proper disposal ofyour auto-injectors Be sure to properly dispose of used auto-injectors;they cannot be reused1
1.Check for a ResponseGive person a light shake, say person’s name, firmly rub person’s sternum(i.e., bone in center of chest where ribs connect) with knuckles, hand in a fist.If persondoes not respond(i.e., wake upand stay awake)—Give Naloxoneand Call 9112
2.Give Naloxone—Call 911 Pull auto-injector from case and follow voice instructions(see page 8 for detailed instructions). When calling 911, give the address and say the person is not breathing.How to Give Naloxone1. Pull the auto-injector from the outer case2. When you are ready to use the auto-injector, pull firmly toremove the red safety guard (do not touch the black base)3. Place the black end against the middle of the outer thigh,through clothing if necessary4. Press firmly and hold in place for 5 seconds3
3.Airway OpenMake sure nothing is in the person’s mouth. If overdose is witnessed (i.e., you see the person stop breathing).Rescue Breathing1. Place face shield(optional)2. Tilt head back, lift chin,pinch nose3. Give 1 breath every5 seconds4. Chest should rise4
If collapse is unwitnessed (i.e., you find someone not breathing)Chest Compressions1. Place heel of one hand over center of person’s chest(between nipples)2. Place other hand on top of first hand, keeping elbowsstraight with shoulders directly above hands3. Use body weight to push straight down, at least2 inches, at rate of 100 compressions per minute4. Place face shield (optional)5. Give 2 breaths for every 30 compressions5
4.Consider Naloxone AgainTwo situations in which to consider naloxone again: If person doesn’t start breathing in 2–3 minutes give second doseof naloxone If person starts breathing after first dose, because naloxone wearsoff in 30 to 90 minutes, a second dose may be needed if person stopsbreathing again Be sure to stay with person until emergency medical staff takeover or for at least 90 minutes to make sure person doesn’t stopbreathing again6
5.Recovery PositionIf the person is breathing but unresponsive, put the person on his/her side toprevent choking if person vomits7
How to Usethe NaloxoneAuto-Injector**This guide is not meant to replacethe auto-injector instructions. Pleasereview the instructions included withyour auto-injector.8 Pull theauto-injector fromthe outer case Pull firmly toremove the redsafety guard (do nottouch the black base)
ResourcesConsider seeking long-term helpat your local VA Substance UseDisorder Treatment Program:CUT LINE Place theblack endagainst themiddle ofthe outerthigh,throughclothing if necessary, then press firmly andhold in place for 5 secondsVA Substance Use Disorder Treatment Program Locator:www2.va.gov/directory/guide/SUD.asp If no reaction in 2–3 minutes or if theperson stops breathing again, give the seconddose of naloxone using new auto-injector Local Emergency Services: 911 National Poison Hotline: 1-800-222-1222 Veterans Crisis Line: 1-800-273-TALK (8255),or text – 8382559
Buddies take care of Buddies.Share this card witha friend or family member.Help is available anytime.www.va.gov Consider seeking long-term help at your localVA Substance Use Disorder Treatment Program:www2.va.gov/directory/guide/SUD.asp Local Emergency Services: 911 National Poison Hotline: 1-800-222-1222 Veterans Crisis Line: 1-800-273-TALK (8255),or text – dapted from the Harm Reduction Coalition, Oakland, CA)Created: January 2016C10January 2016IB 10-780, P96782
Keep two auto-injectors with you at all times Store auto-injectors at room temperature, away from light Keep auto-injectors out of the heat or cold—e.g., do not store in your car—otherwise naloxone will lose its effectiveness If you use an auto-injector or your auto-injectors expire, contact your provider as soon as possible for
Auto-injector (EvzioTM) - Approved in 2014 - 0.4 mg/0.4 mL naloxone in a pre-filled auto-injector - Two auto-injectors and one trainer per package - May not be readily available in all pharmacies due to cost. Naloxone Rescue Kits, Jen Plumb, MD, MPH 11/2/2016 15
2 Valve body KIT M100201 KIT M100204 KIT M100211 KIT M100211 KIT M100218 KIT M300222 7 Intermediate cover (double diaphragm) - - - KIT M110098 KIT M110100 KIT M110101 4 Top cover KIT M110082 KIT M110086 KIT M110092 KIT M110082 KIT M110082 KIT M110082 5 Diaphragm KIT DB 16/G KIT DB 18/G KIT DB 112/G - - - 5 Viton Diaphragm KIT DB 16V/S KIT
HOW TO USE EPIPEN , EPIPEN JR (EPINEPHRINE) AUTO-INJECTOR AND EPINEPHRINE INJECTION (AUTHORIZED GENERIC OF EPIPEN ), USP AUTO-INJECTOR, MYLAN AUTO-INJECTOR, MYLAN 1. Remove the EpiPen or EpiPen Jr Auto-Injector from the clear carrier tube. 2. Grasp the auto-injector in your
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6. Create and maintain naloxone use report form and log (see Appendix 2 for template) 7. Replace naloxone kits that are damaged, unusable, expired, or used. B. Each IM (intramuscular) naloxone kit shall include: 1. Instructions for administration of naloxone (see Appendix 3 for example); 2. Two IM syringes (preferably 22-25g, 1-1.5”, 3cc) and 3.
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letter. A copy of a naloxone standing order or physician’s prescription. If the naloxone request is for more than 48 units, the organization/entity must provide a brief and comprehensive summary explaining why the quantity was requested and the plan for distribution. Send the application and supporting documents to Naloxone@dhcs.ca.gov.
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