Naloxone HCL (Narcan®)

• Intranasal (IN) rapid push
  
• Slow IV or IO push
  
• IM (alternate route)
  
• Subcutaneous (least preferred route)

Adult Dose:

Non-cardiac arrest - Standing order

• 0.4 mg every 5 minutes slow push until the respiratory rate improves and the patient can maintain a pulse oximetry reading of 96% OR until 2 mg given
  

Cardiac Arrest - Standing Order

• 2 mg IV or IO push

Non-cardiac arrest - Standing order

• 0.1 mg/kg slow push (maximum single dose 0.4 mg) until the respiratory rate improves and the patient can maintain a pulse oximetry reading of 96% OR until 2 mg given
  

Cardiac Arrest - Standing order

• 0.1 mg/kg slow push (maximum single dose 2.0 mg)

• Narcotic overdose
  
• Coma of unknown origin
  
• Cardiac arrest with suspected narcotic overdose etiology
  
• Seizure with suspected narcotic overdose etiology

• Effective for only 30 - 60 minutes; repeat if LOC and/or respiratory status deteriorate
  
• Secure patient prior to administration
  
• Not recommended as part of initial resuscitative efforts for newborns with respiratory depression
  
• Avoid administration in babies whose mothers are suspected of having had long term exposure to opiods

• Tachycardia
  
• Hypertension
  
• Diaphoresis
  
• Nausea
  
• Blurred vision

• Acute withdrawal syndrome (violent behavior)
  

With rapid administration:

• Arrhythmia
  
• Projectile vomiting