PAP.18.5.030 Procedures:
(a) Nasal Naloxone Coordinator
The Equipment Manager is designated as the Nasal Naloxone Coordinator. The Nasal Naloxone Coordinator shall be responsible for the following:
(1) Ensuring Nasal Naloxone kits are current and not expired,
(2) Proper dissemination of Nasal Naloxone kits.
(3) Replacement of any Nasal Naloxone kits that are either damaged, unusable, expired or deployed.
(4) Ensuring all personnel that will be administering Nasal Naloxone kits have received appropriate training.
(5) Ensuring that any administration of Nasal Naloxone is documented by a Nasal Naloxone report.
(b) Location of Nasal Naloxone Kits
(1) Desk Sergeant/Booking area
(2) Two kits in each patrol car
(A) K-9 Unit, Detective Bureau, Community Policing Officers/School Resource Officers and as directed by the Chief of Police.
(3) Nasal Naloxone may be damaged by extreme temperatures, both high and low. Due to this fact, consideration should be given to storing Nasal Naloxone in the interior of a patrol car when these conditions exist When the Officer's shift is complete, the Officer shall remove the kit from the patrol car and store the kit inside the police department or their residence.
(c) Nasal Naloxone Deployment Protocol
Officers shall maintain universal precautions.
(1) Officer(s) shall notify their communications dispatch that the subject is in an overdose state.
(2) Dispatcher then notifies the local EMS and Paramedic Unit.
(3) Identify and assess the subject for responsiveness, pulse and status of breathing.
(4) In no pulse, initiate CPR and AED per normal protocol, notifying incoming EMS.
(5) If pulse is present and the subject is unconscious, assess breathing status:
(A) If breathing is adequate (>8 per minute, no cyanosis) and no signs of trauma, place in the recovery position.
(B) If breathing Is decreasing or signs of low oxygen (cyanosis) and overdose is suspected (based on history, evidence on the scene, bystander reports, physical examination) then proceed with Nasal Naloxone kit administration.
(6) Retrieve Nasal Naloxone kit.
(7) Assemble Nasal Naloxone kit.
(8) Administer a maximum of 1 mg in each nostril for a total of 2 mg using the mucosal atomizer device.
(9) Initiate breathing support with pocket mask, bag-valve-mask and oxygen if available.
(10) In no response after 3-5 minutes and a second dose of nasal naloxone is available, repeat the administration.
(11) Continue to monitor subject's breathing and pulse. If breathing increases and there is no evidence of trauma, place subject in the recovery position.
(12) If at any time the subject's pulse is lost, initiate CPR and AED per normal protocol.
(13) Keep advising EMS of subject's status when able to do so.
(14) Provide EMS with a full report when they arrive on the scene.
(15) Release the care of the subject to EMS.
(16) If the subject is transported to a medical facility by ambulance, for all practical purposes the Officer should accompany ambulance personnel for their safety.
(17) Complete documentation and internal department procedures for restocking and notification.
(d) Maintenance/Replacement
(1) An inspection of the nasal naloxone kit, including checking the expiration date of the kit, shall be the responsibility of the Officer during each shift.
(2) Missing or damaged nasal naloxone kit(s) shall be reported directly to the person in charge of the shift who shall then notify the Nasal Naloxone Coordinator.
(3) When any condition necessitates a nasal naloxone kit be submitted for replacement, information shall be directed to the Nasal Naloxone Coordinator. If expired, the Nasal Naloxone Coordinator shall be notified as soon as possible.
(e) Documentation/Nasal Naloxone Report
(1) Upon administration of a nasal naloxone kit, the Officer shall complete a nasal naloxone administration report detailing the nature of the incident, the care the subject received and the fact that the nasal naloxone was administered.
(2) The report shall be forwarded to the Nasal Naloxone Coordinator.
(3) After approval from the Nasal Naloxone Coordinator the report shall be forwarded to the Sawyer County Prosecutor's Office Nasal Naloxone Coordinator. (These records must be completed for statistical value and tracking of the Nasal Naloxone administration by law enforcement personnel).