On Monday, August 1, 2016, the Southern Manatee Fire Rescue District deployed the new Naloxone (Narcan) nasal spray kits in its efforts in trying to save the life of patients that have overdosed on heroin. Prior to placing this medication on all Fire Apparatus, the District utilized the Naloxone (Narcan) auto-injectors which contained .4mg of Narcan.
The treatment protocols allowed for our personnel to administer Narcan 1 dose of .4mg via the auto-injector when a patient exhibited the signs and symptoms of respiratory depression and if no change in the respiratory drive, then they could administer a 2 dose of .4mg.
Since the vast majority of our overdoses were from heroin mixed with other potent opioids such as fentanyl or carfentanil, which is considered to be 10,000 times more potent than morphine, multiple doses of Narcan had to be administered just to restore breathing.
Because of this we worked with the County Medical Director over this new Narcan which is a much higher dose, 4mg instead of .4mg and it is administered intranasal, which absorbs through the capillary bed on the inside of the nose. The County Medical Director approved this new dosage and route of administration and our protocols were revised to add this new medication and route of administration.
In treating an overdose patient our goal is NOT to awaken them, it is simply to restore breathing. Since deployment of this new and higher dosage we have seen a better response in restoring an overdosed patient’s respiratory drive.
Since October 1, 2015 to August 31, 2016, the Southern Manatee Fire Rescue District responded to over 289 overdose incidents and have administered over 200 doses of Narcan and a lot of these incidents were multiple patient incidents, meaning 2 or more patients at one time.