Just to toss some gasoline on the flames: Here in New Mexico, EMT-Basics are allowed to give Narcan AND use it *diagnostically*. In cases of unconscious/unresponsive patients with no known cause, Basics may administer 0.4mg Narcan IM/SQ on standing orders up to 2mg. Basics may also administer Narcan intra-nasally.
NALOXONE (NARCAN®)
CLASS OF DRUG
Narcotic antagonist
INDICATIONS
1. Reversal of narcotic effects, particularly respiratory depression, due to narcotic drugs, whether
ingested, injected, or administered in the course of treatment. Narcotic drugs include agents
such as morphine, Demerol®, heroin, Dilaudid®, Percodan®, codeine, Lomotil®, propoxyphene
(Darvon®), pentazocine (Talwin®).
2. For unconsciousness of unknown etiology to rule out (or reverse) narcotic depression of CNS.
CONTRAINDICATIONS
1. Hypersensitivity
2. Absences of indication
DRUG INTERACTION
1. May induce narcotic withdrawal
ADMINISTRATION
Adult: [0.4 mg – 2.0 mg] IVP (2.0 mg total dose) - [0.4 – 2.0 mg] if IM, SQ, ET
Titrate to respiratory effort/rate. May be repeated at 2 - 3 minutes, if needed.
[2mg (1mg per naris)] IN
Pediatric: [0.1 mg/kg]< 5 yrs or 20 kg, [2 mg] 5 yr or > 20kg IV, ET, IM, SQ, IO,
May be repeated at 0.1 mg/kg if no response.
Neonate: [0.1 mg/kg] slow IVP, ET, IM, SQ, IO; repeat in 2-3 minutes, if needed
(mix 1 ml of naloxone, 0.4 mg in 9 ml of D5W, which gives 0.04 mg/ml)
Note: Much higher doses should be given to patients with suspected propoxyphene
(Darvon®), pentazocine (Talwin®), and fentanyl overdoses.
SPECIAL NOTES
1. The patient may quickly become conscious and combative.