How to Detect and Respond to a Fentanyl Overdose
More and more, communities ravaged by synthetic opioids are opting for a pragmatic response — training the public, and opioid users’ family members, in rapid overdose response. Here’s four steps for helping someone who’s overdosed, based on materials from San Francisco’s Department of Public Health and the Substance Abuse and Mental Health Services Administration. (Whether or not you have naloxone, call 911 immediately.)
Signs of an overdose include unconsciousness and slow or shallow breathing. If someone is not responding, see if you can bring them back to consciousness by yelling something like, “Hey, are you OK?” If loud voice commands don’t work, clench your hand into a fist and rub your knuckles back and forth on the person’s sternum, the bony middle part of the ribcage. Because this feels uncomfortable, it can sometimes rouse people even when shouting doesn’t.
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If the person still won’t respond and/or if they’re not breathing, administer naloxone (Narcan), an opioid antagonist that swiftly reverses fentanyl’s eects on the brain. (If you’re not carrying naloxone yourself, bars, restaurants, and stores may have it behind the counter.) Insert the nozzle of the naloxone inhaler partway into the person’s nostril and press hard on the plunger to dispense the dose. If two minutes have passed since the first dose of naloxone and the person has not revived, administer a second dose using a new dispenser.
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If the person remains unresponsive, perform rescue breathing to deliver oxygen to the brain while you wait for emergency personnel to arrive. Pinch their nose shut, tilt their head back to open the airway, and direct two full breaths into their mouth followed by one full breath every five seconds, forming a seal to prevent air from escaping. (Many first aid kits and AEDs include a face shield that can be used to deliver rescue breaths while helping protect against disease transmission.) If you are doing this correctly, you will see the person’s chest rise and fall as you breathe.
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If you can tell that the person has gone into cardiac arrest, combine rescue breathing with chest compressions, a technique known as CPR. With your arms extended, press hard and fast on the center of the chest. ( The American Heart Association recommends doing this to the beat of the song “Stayin’ Alive.”) Continue doing this — in the form of 30 chest compressions followed by two rescue breaths — until the person responds, or emergency personnel arrives.