Overdose: Narcotics (Adult)
 
Status
Suspected Narcotic Overdose
   
Stop
• Ensure personal / crew safety
• Scene may have concealed syringes
   
Assess evidence of narcotic overdose
- Altered conscious state
- Pin point pupils
- Respiratory depression
- Track marks
- Substance involved
- Exclude other causes (inc. obvious head injury)
   
Narcotic overdose
Assist and maintain airway/ventilation
Naloxone 1.6mg–2mg IM
   
Adequate response
BLS
Consider transport
 
   
Inadequate response after 10 minutes
Naloxone 0.8mg IM
Consider airway Mx Laryngeal Mask
Naloxone 0.8mg IM or IV
Consider airway Mx Intubation
 
Special Notes
Narcotics may be in the form of IV preparations such as Heroin or Morphine and oral preparations such as Codeine, Endone, MS Contin. Some of these drugs also come as suppositories.
Not all narcotic overdoses are from IV administration of the drug.
 
General Care
If inadequate response after 10 minutes, Pt is likely to require transport without delay.
- Maintain general care of the unconscious Pt and ensure adequate airway and ventilation.
- Consider other causes e.g. head injury, hypoglycaemia, polypharmacy overdose.
- Beware of Pt becoming aggressive.