INSERT YOUR ORGANIZATION NAME HERE

Title:
Opioid Overdose Prevention, Recognition, and Response Policy
Category:
All
Effective Date: / Revision Date:

PURPOSE

To provide operating procedures for opioid overdose prevention, recognition, and response.

EMPLOYEES AFFECTED:

[AGENCY NAME] employees who might witness an opioid overdose during the course of their work.

POLICY:

It is the policy of [AGENCY] to offer training on opioid overdose prevention, recognition, and response, including the use of naloxone, to all employees. Because preventing death from overdose is a community concern, the same trainings are available for participants/patients/clients/residents.

RESPONSIBILITY:

The "Health Care Professional" is responsible for:

  • Reviewing training materials
  • Approving master trainers
  • Providing the standing order or other means of providing naloxone access
  • Reviewing adverse events

The "Program Director” is responsible for:

  • Ensuring program requirements are met, including collecting and submitting forms
  • Ensuring that [AGENCY] has at least one master trainer at all times
  • Ordering and monitoring relevant program supplies

A master trainer is capable of providing train-the-trainer sessions.

  • A trainer is a nonmedical employee who has received training and orientation by a master trainer, and may educate other nonmedical employees involved in opioid overdose prevention, recognition, and response.

PROCEDURE:

Oversight

A health care professional will provide clinical consultation, serve as an advisor concerning medical issues, approve master trainers, and review reports of all administrations of an opioid antagonist.

A program director will serve as the overdose prevention and response implementation lead and identify overdose trainers from within the agency, maintain records of trainings, be a liaison with emergency medical services, report all administrations of an opioid antagonist, and review all incidents of overdose responses.

Overdose educators are identified by the implementation lead and may be staff members at the same organization or community members. Overdose educators train overdose responders. Overdose responders are community members who may or may not be patients or participants, and have received education and materials to respond to suspected opioid emergencies.

Training and materials for overdose response will be available to participants and employees upon request. Existing emergency response kits will include naloxone and an accompanying delivery device.

Training

Employees will receive training on overdose prevention, recognition, and response on a rotational schedule. Participants may receive training and materials upon request.

Opioid overdose or poisoning recognition

(accessed from the Harm Reduction Coalition

The following are signs of an overdose:
  • Loss of consciousness
  • Unresponsive to outside stimulus
  • Breathing is very slow (fewer than 8 breaths per minute), shallow, erratic, or has stopped
  • For lighter skinned people, the skin tone turns bluish purple, for darker skinned people, it turns grayish or ashen; Fingernails and lips turn blue or purplish black
  • Choking sounds, or a snore-like gurgling noise (sometimes called the “death rattle”)
  • Pulse (heartbeat) is slow, erratic, or not there at all

Participants are encouraged to immediately report any suspected overdose events to employees and call 911. No participants will receive an interruption in their services or negative programmatic consequence as a direct result of reporting or experiencing a suspected overdose.

Opioid overdose or poisoning response

Agency staff should call 911 for an overdose emergency, even if the overdose victim has resumed consciousness following the administration of rescue breathing and/or naloxone. People may refuse care or transport against medical advice once EMS arrives. All AMA decisions will be documented in the incident report.

Employees trained as overdose responders suspecting an opioid overdose should follow these steps:
  • Establish whether the participant is responsive.
  • If there is no response, call 911.
  • Deliver one dose of naloxone.
  • If sufficient protective equipment is available, begin rescue breathing. **If protective equipment is not available, skip this step.
  • If there is no response after 2-3 minutes, deliver second dose of naloxone.
  • If the participant must be left unattended, place them in the rescue position.
  • Fill out an incident report and notify supervisor

Documentation

Following an overdose, employees will fill out and submit an incident report to their supervisor and the Chief Operating Officer. The Chief Operating Officer will report to Risk Management and will follow up with participants and staff to debrief the event. Supervisors will provide relevant support to employees including but not limited to information on the Employee Assistance Plan.