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Opioid Overdose Rescue with Naloxone Nasal Spray (4 mg)

Medication Instructions

Illustration of a hand holding the nasal spray.

  • Keep two naloxone nasal sprays with you at all times.

  • Store naloxone nasal sprays at room temperature (59⁰ to 77⁰ F), away from light. Avoid extremes of heat or cold (for example, do not freeze nasal spray).

  • If you use a naloxone nasal spray or your naloxone nasal sprays expire, contact your provider as soon as possible for a replacement. Naloxone nasal sprays should be replaced before the expiration date on the box.

  • Throw away (dispose of) any used naloxone nasal spray device in a place that is away from children.

  • Each nasal spray contains one dose and cannot be reused.

How to use the medicine

Step 1 Check for a response.

Give 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.

Image of a man lying on his back with a fist rubbing his sternum.

If person does not respond (i.e. wake up and stay awake)--Give naloxone and call 911.

Step 2 Give naloxone--Call 911.

  • Spray naloxone nasal spray into one nostril (see page 8 for detailed instructions).

  • When calling 911, give the address and say the person is not breathing.

How to give naloxone

Image of a person inserting nasal spray into an unconscious woman’s nose.

  1. Remove naloxone nasal spray from the box.

  2. Peel back the tab with the circle to open the naloxone nasal spray.

  3. Hold the naloxone nasal spray with your thumb on the bottom of the plunger and your first and middle fingers on either side of the nozzle.

  4. DO NOT PRIME OR TEST THE SPRAY DEVICE. Tilt the person’s head back and provide support under the neck with your hand. Gently insert the tip of the nozzle into one nostril, until your fingers on either side of the nozzle are against the bottom of the person’s nose.

  5. Press the plunger firmly to give the entire dose of naloxone nasal spray. Remove the naloxone nasal spray from the nostril after giving the dose.

Step 3 Airway open.

Make sure nothing is in the person’s mouth.

  • If overdose is witnessed (for example, you see the person stop breathing) ...

Rescue breathing

Woman giving an unconscious man rescue breaths.

  1. Place face shield (optional).

  2. Tilt head back, lift chin, pinch nose.

  3. Give 1 breath every 5 seconds.

  4. Chest should rise.

  • If collapse is unwitnessed (for example, you find someone not breathing)

Chest compressions

Man giving unconscious person chest compressions.

  1. Place heel of one hand over center of person’s chest (between nipples).

  2. Place other hand on top of first hand, keeping elbows straight with shoulders directly above hands.

  3. Use body weight to push straight down, at least 2 inches, at rate of 100 compressions per minute.

  4. Place face shield (optional).

  5. Give 2 breaths for every 30 compressions.

Step 4 Consider naloxone again.

There are 2 situations in which to consider naloxone again:

  • If person doesn’t start breathing in 2-3 minutes give second dose of naloxone.

  • If person starts breathing after first dose, because naloxone wears off in 30 to 90 minutes, a second dose may be needed if person stops breathing again.

    • Be sure to stay with person until emergency medical staff take over or for at least 90 minutes to make sure person doesn’t stop breathing again. 

Step 5 Recovery position.

If the person is breathing but unresponsive, put the person on his/her side to prevent choking if person vomits.

Person moving unconscious man’s arm into a bent position over the shoulder.

Person moving unconscious man’s knee and shoulder to position him on his side.

Image of unconscious man lying on his side.

How to use naloxone nasal spray*

1. Remove naloxone nasal spray from the box.

2. Peel back the tab with the circle to open the naloxone nasal spray.

Close-up view of hands opening naloxone nasal spray box.

3. Hold the naloxone nasal spray with your thumb on the bottom of the plunger and your first and middle fingers on either side of the nozzle.

Hands are holding the nasal spray which is labeled “nozzle” and “plunger.”

4. DO NOT PRIME OR TEST THE SPRAY DEVICE. Tilt the person’s head back and provide support under the neck with your hand. Gently insert the tip of the nozzle into one nostril, until your fingers on either side of the nozzle are against the bottom of the person’s nose.

5. Press the plunger firmly to give the entire dose of naloxone nasal spray. Remove the naloxone nasal spray from the nostril after giving the dose.

6. If no reaction in 2-3 minutes or if the person stops breathing again, give the second dose of naloxone in the other nostril using a new naloxone nasal spray.

Image of a person inserting nasal spray into an unconscious woman’s nose.

*This guide is not meant to replace the nasal spray instructions. Please review the instructions included with your nasal spray.

Resources

Consider seeking long-term help at your local VA 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 -- 838255

Author: StayWell Custom Communications
Last Annual Review Date: 2/1/2017
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