Naloxone must be readily available on all wards where opioids are used.
All trained nursing staff should know where it is stored.
Is patient’s respiratory rate 7 and a sedation score of 2?
Is the patient’s sedation score 3?
Prepare solution in a 5ml syringe using 3mls of 9% sodium chloride and 400 micrograms (1ml) NALOXONE, checking expiry date of both drug and diluent.
Administer the Naloxone intravenously in 100mcg increments every minute, until the respiratory rate if greater then 10 and the patient’s sedation score is 0 or 1.
Maximum dose of Naloxone should be 400 micrograms. If this dose has not given an adequte response then respiratory depression may not be caused by opioid excess?
OTHER CAUSES SHOULD BE CONSIDERED. Please ask for surgical review
Sign the pain controlled analgesia (PCA) chart in the emergency drug section.
Monitor respiration rate, sedation score and oxygen saturations every 15 minutes for 1 hour and hourly for 4 hours thereafter, to ensure respiratory depression does not return. Pulse oximetry should be used continuously until opioids are no longer required.
Contact the Acute Pain Nurse or ITU Anaesthetist to reassess the patient’s analgesia requirements and whether a Naloxone infusion is required.