Naloxone for Opioid Overdose
The rescue drug alone isn’t enough.
Sadly, opioid overdose is an epidemic in the United States, taking the lives of 70,000 Americans in 2021 alone. On March 29, 2023, the FDA approved the first-ever naloxone product (Narcan Nasal Spray) for over-the-counter (OTC) non-prescription use. This product is a nasal spray and is the reversal agent for opioids. While easy to administer, the situation surrounding Narcan Nasal Spray can pose many challenges. Providers must be able to engage help and manage emergencies. Anyone who plans to administer Narcan Nasal Spray needs to train on both its use and managing a team in an emergency to give the patient the best probability of survival. A common response I hear is, “How hard could it be?”
Here I will provide a few topics for consideration when using Narcan Nasal Spray and why training is important:
Should you administer Narcan Nasal Spray to every unconscious patient?
What are the signs of an opioid overdose, and when should you suspect it?
What do you do if the patient is not breathing?
Where do you find Narcan Nasal Spray?
Is the scene safe?
How do you elicit help?
How do you direct others to assist?
When do you contact 911?
What do you do if Narcan does not change the patient's condition?
How long until Narcan Nasal Spray takes effect?
How long until Narcan wears off?
Given the multitude of factors that a first responder must account for, how should we prepare students to handle opioid overdoses? Luckily, a unified set of teamwork principles exists that tackles these issues. Known as "Crisis Resource Management," these principles were derived from practices in the aviation industry. The application of Crisis Resource Management (CRM) is now widespread within the healthcare sector.
The principles included in CRM include:
Situational Awareness
Leadership
Workforce Distribution
Communication
Anticipation and Planning
Resource Utilization
Understanding these principles and how to implement them is important in addressing any healthcare emergency, including opioid overdose. Detailed information on CRM is available at:
https://www.ncbi.nlm.nih.gov/books/NBK551708/
However, merely understanding these principles isn't sufficient; they must be put into practice. The most effective way to exercise these principles is through team-based simulation, particularly using a technique known as "Rapid Cycle Deliberate Practice." This simulation technique entails the repetition of an emergency situation multiple times. After each simulated scenario, a facilitator gives feedback centered on CRM principles to the team, and then the scenario is run again. Moreover, the facilitator has the discretion to pause the scenario midway to provide immediate corrections before resuming. This method of simulation offers an effective and efficient means of training in CRM for a range of emergency situations, including opioid overdose.
SimRated’s course “Naloxone for Opioid Overdose” covers the administration of Narcan Nasal Spray and Crisis Resource Management.
We would love to talk to you about how our procedure courses can prepare you students for careers in the medical field. Set up a demo HERE!
Resources:
https://www.fda.gov/consumers/consumer-updates/access-naloxone-can-save-life-during-opioid-overdose