Clarification of Basic Life Support for the Naloxone Programme

cprThe national naloxone programme is a unique innovative programme with the primary aim of providing immediate intramuscular injection of naloxone to reverse the effects of opiate overdose. The recommended CPR is an additional adjunct to the programme.

This briefing note provides pragmatic guidance on the CPR element of the naloxone programme and is based on authoritative best practice guidance.

The aim of the Naloxone Programme (NP) is to administer naloxone to individuals suspected of overdosing on opiates as soon as possible. Opiate intoxication will result in a respiratory arrest, cardiac arrest is a secondary event. Basic life support (BLS) guidelines are primarily intended to improve the outcome for cardiac arrest. The updated BLS guidelines 2010 refer to maintaining the airway and supporting breathing and circulation without equipment as simply as possible. It is recommended that once CPR has started the rescuer should only stop if the victim shows signs of life. It is not recommended that a pulse is checked and it is only necessary to ascertain if breathing is normal.

In ideal circumstances and performing CPR correctly each cycle of 30 compressions and 2 breaths will take 24 seconds and 5 cycles will equate to 2 minutes. It should be noted that the European guidelines make no reference to timing.

The primary aim of the NP is to administer naloxone. Inevitably the CPR process has to be interrupted as assembly and administration of the naloxone injection is required. Naloxone needs to be given every 2 minutes and in order to achieve this a pragmatic approach of 3 cycles of CPR is recommended.

April 2013.

Briefing note prepared on behalf of the National Naloxone Advisory Group
Dr Sam Perry , Medical Lead, NNAG
Dr Carole Hunter, Chair, NNAG.