Overdose Reversal Kits
Arkansas Act 811 requires public high schools and state-supported universities to have opioid overdose reversal kits.
School districts are strongly encouraged to develop protocols for storage and use of the kits.
District leaders can use the following information to support protocol development and to educate staff, students, and family members.
Precautions When Giving Naloxone
When an overdose is suspected, helpers should call 911 so the individual can receive immediate medical attention. Naloxone, the generic name for the drug NARCAN®, works to reverse opioid overdose in the body for only 30 to 90 minutes. But many opioids remain in the body longer than that. It is possible for a person to still experience the effects of an overdose after a dose of naloxone wears off. Also, some opioids are stronger and might require multiple doses of naloxone.
People Who Are Given Naloxone Should Be Observed Constantly Until Emergency Care Arrives
They should be monitored for another two hours after the last dose of naloxone is given to make sure breathing does not slow or stop. People with physical dependence on opioids may have withdrawal symptoms within minutes after they are given naloxone.
Withdrawal symptoms might include:
- Headaches
- Changes in blood pressure
- Rapid heart rate
- Sweating, nausea, vomiting and tremors
While these symptoms are uncomfortable, they are usually not life threatening. The risk of death for someone overdosing on opioids is worse than the risk of experiencing withdrawal symptoms as a result of naloxone administration. Clinicians in emergency room settings are being trained to offer patients immediate relief and referral to treatment for opioid use disorder with effective medications after an opioid overdose is reversed.
Two State Laws Protect Helpers
Joshua Ashley-Pauley Act
A person who is overdosing – or a bystander trying to help a person who is overdosing – will not be charged with drug possession if they call for medical assistance. The act I named for a 20-year-old UCA student who died from a drug overdose because the people who were with him were afraid they would be prosecuted if they called for medical help.
Opioid Antagonist Immunity Act
This law protects people who administer naloxone from civil lawsuits, criminal charges, and professional sanctions.
Training Video Examples
Introduction (45 sec)
Training (2 min 15 sec)
Joshua Ashley Pauley (50 sec)
Reporting the Use of Naloxone
To track the efficacy of programs providing naloxone for community use and to provide data on statewide prevention efforts, when naloxone is administered the person who administered the dose is asked to complete the Naloxone Reporting Tool. This online survey is mobile compatible and comprised of a total of 24 questions, some required and some optional. Those in a position to administer naloxone are encouraged to review the questions before an emergency arises.
What Is NARCANas?
Through a partnership with multiple agencies and organizations, NARCANsas.com is a mobile compatible information hub for the prevention, treatment, and recovery of opioid use in Arkansas. Download the NARCANsas app to your phone to have instant access to the step-by step naloxone administration reference and reporting tool as well as many other resources.
Naloxone Administration Protocol
Recognize
Observe student for signs and symptoms of opioid overdose. Suspected or confirmed opioid overdose consists of:
- Respiratory depression evidenced by slow respirations or no breathing (apnea)
- Unresponsiveness to stimuli (such as calling name, shaking, sternal rub)
- Suspicion of opioid overdose can be based on:
- Presenting symptoms
- History
- Report from bystanders
- School nurse or staff prior knowledge of student
- Nearby medications, illicit drugs, or drug paraphernalia
Opioid High | Opioid Overdose |
---|---|
Relaxed muscles | Pale, clammy skin |
Speech slowed | Speech infrequent |
Normal breathing | No breathing or shallow breathing |
Appears sleepy, nodding off | Deep snorting or gurgling |
Responds to stimuli | Unresponsive to stimuli (calling name, shaking or sternal rub) |
Normal heartbeat/pulse | Slowed heartbeat/pulse |
Normal skin color | Cyanotic skin coloration (blue or gray lips, fingertips) |
Typical pupil size | Pinpoint pupils |
Respond
Immediately call for help.
- Call 911.
- Assess breathing. Perform rescue breathing if needed.
- Place student on their back.
- Tilt the chin up to open the airway.
- Check for and remove anything in the mouth blocking the airway, such as gum, toothpick, undissolved pills , syringe cap or cheeked Fentanyl patch.
- If using a mask, place and hold mask over mouth and nose. If not using a mask, pinch the nose with one hand and place your mouth over the student’s mouth.
- Give 2 even, regular-sized breaths.
- Blow enough air into the lungs to make the chest rise.
- If using a mask and the chest does not rise, tilt the head back more and make sure the seal around the mouth and nose is secure. If not using a mask and the chest does not rise, tilt the head back more, and make sure you are pinching the nose.
- Breathe again. Give one breath every 5 seconds.
Resources
- Arkansas Department of Education guidance regarding Act 811
dese.ade.arkansas.gov - Information, resources, and a free mobile app for opioid overdose prevention, rescue, and recovery in Arkansas
NARCANsas.com - Video guidance for administering naloxone produced by the California Department of Public Health
Administering Naloxone - Video instructions for administering NARCAN® Nasal Spray produced by the manufacturer, Emergent Biosolutions
Administering Narcan - Opioid safety information from the Family Health Centers of San Diego
fhcsd.org/opioid-safety - National Association of School Nurses
nasn.org - Naloxone facts from the National Institute on Drug Abuse
nida.nih.gov/publications/drugfacts/naloxone - If you administer naloxone, please fill out the Arkansas Naloxone Reporting Tool.
bit.ly/2j0rBo5