Notes
- Suspected Opioid Overdose
- Unresponsiveness
- Ensure that the scene is safe. Check for unresponsiveness. Gently tap the person’s shoulder. Ask, “Are you OK?”
- Simultaneously access the person’s breathing and pulse.
- Check for breathing. Is the breathing normal, no breathing, or abnormal (only agonal gasps)?
- Assess the carotid pulse and look for other signs of circulation (no more than 10 sec). If signs of circulation are present but the person is still not breathing, give rescue breaths at the rate of 10 breaths/min (1 breath every 6 seconds).
- In a sudden collapse, if you are alone and there is no response with no breathing or abnormal breathing (only agonal gasps) and no pulse, summon help, call a code, activate EMS response via mobile device (if appropriate), phone 911, and get an automated external defibrillator (AED) and naloxone, if available. Send a second rescuer, if available, for help.
- Position the person supine on a hard, flat surface.
- If a pulse and signs of circulation are not present, begin chest compressions.
- Place the heel of one hand on the center of the chest over the lower half of the breastbone; place the heel of your other hand over the first.
Firmly compress the chest at least 2.0 in. Push hard and fast. Give 30 compressions. Compress at a rate of 100–120/min. Ensure complete chest recoil after each compression. Avoid leaning on the chest between compressions. - If the person is not breathing, begin rescue breaths. Open the airway by the head tilt-chin lift method or, if spinal injury is suspected, use the jaw thrust method, if possible.
- Using a face mask or barrier device, give 2 breaths (1 sec each) with sufficient volume to cause the chest to rise. Do not overventilate. Note: If the chest does not rise, reposition the head, chin, and jaw, and give 2 more breaths. If the chest still does not rise, follow instructions for unconscious adult with an obstructed airway.
- Continue to give 30 compressions followed by 2 breaths until an AED and naloxone arrive.
- Administer naloxone as soon as it is available. Give intranasally: 2 mg, repeated every 3–5 min, if necessary.
- Does the person respond?
- Yes: If adequate breathing and circulation resume, place the person in the recovery position and monitor until help arrives. If the person stops responding, begin CPR and repeat naloxone.
- No: Continue CPR and use the AED as soon as it is available. Continue until the person responds or until advanced help arrives.