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Copy of Example Staff training- 'Overdose intervention using Prenoxad Injection (naloxone hydrochloride 1mg/1ml solution for injection).

Prenoxad Injection is licenced by Martindale Pharma. More info at www.prenoxadinjection.com Videos here may take a few moments to load. Be patient :)

Stephen Malloy

on 25 November 2015

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Transcript of Copy of Example Staff training- 'Overdose intervention using Prenoxad Injection (naloxone hydrochloride 1mg/1ml solution for injection).

Prenoxad Injection
Overdose Intervention

Demonstrate clear understanding of overdose prevention and naloxone messages

Able to identify/communicate observable signs of overdose

Able to demonstrate an awareness of emergency life support skills needed in overdose intervention

Ability to demonstrate the administration of Prenoxad Injection community pack, offer after care to casualty

Recognise the importance of calling an ambulance

Anything else??
Overdose Awareness
Outcomes from session
Main drugs involved

Physical effects
Risk factors/causes

High risk times

Signs and symptoms*


Correct actions

Calling 999
Prenoxad Injection
( 2ml naloxone 1mg/1ml) solution for injection)
What is naloxone?
Dealing with the casualty
who's unconscious and
Dealing with the unconscious casualty who is breathing-
The recovery position
Prenoxad injection
kit-assembly and administration


Short Q&A

Short exam
What does it do?
Is it dangerous or harmful?
Can it be abused?
Who can get it?
What's the law on it?
Do I have to give it?
Main Video-When to give Prenoxad Injection
Signs and symptoms of opioid (related) overdose
....lets break it down
Prenoxad Injection pack-
Assembly and administration
Overdose intervention- What NOT to do!
(the birth of the myth?)
Remi Video
The full overdose 'first aid' intervention using Prenoxad Injection.......'What it looks like'
In own or friend’s home
Witnesses present
Sometimes several hours between overdose and death
Recent overdose experience, but survived
Other drugs present
Recent abstinence or reduction in use
Older, experienced injector
Main Drugs Involved
Illicit opiates




...all 'downers'..........
Tolerance level

Poly Drug use- In Particular, Mixing different CNS depressant type drugs (illicit and prescribed)/alcohol

Longer history of drug use and HISTORY OF NON FATAL OVERDOSE
Depression or very low mood?
Significant life events
Poor physical and/or mental health

Using drugs while alone
Injecting drugs(?)
Homeless drug users
Not being in treatment/unsupported/’disconnected’

Any others??
What stops people doing 'the right thing'?
Failure to identify overdose?
Lack of knowledge of correct procedures?
Fear of implication?
Fear of involving authorities in case of negative consequences?
Police involvement?
Times when tolerance may be lowered:
During/Leaving prison or Custody?
During/Leaving rehab or hospital?
Beginning/ending substitute medication?
Any others?

Difficult life events
Bereavement, loss of contact with children, separation,
major stress events, arrest etc
Holiday/festive periods, weekends
Cash windfall times i.e. times with extra cash
Step by step- wont wake up but is breathing.
Attempt to rouse casualty with Voice

Approach with caution

remove any danger if possible

Attempt to rouse Using Noise and touch-shout for help

Perform chin lift and Assess breathing

Recovery position

Then 999/0.4 mls naloxone injected into outer thigh- STAY WITH CASUALTY
Step by step-unconscious and
NOT breathing
Attempt to rouse casualty with voice

Approach with caution

remove any danger if possible

Attempt to rouse using noise and touch-shout for help

Perform chin lift and Assess breathing

CALL 999

1 cycle chest compressions and rescue breaths

Administer 0.4 mls of naloxone into outer thigh

Continue with 3 more cycles of rescue breaths and CPR, then administer 0.4 mls naloxone again and STAY WITH CASUALTY
naloxone hydrochloride
naloxone is a pure competitive opioid antagonist.

It is used for coma or respiratory depression (not breathing enough) caused by opioids. Long history of clinical use (~50yrs)

naloxone can reverse the effects of OPIOID or OPIOID RELATED overdose if used within a short period following an opioid overdose.

Practically safe (ex contra’s- Allergy, pre existing heart conditions, liver disease...etc)
naloxone counteracts the effects of
Codeine and Dihydrocodeine
Buprenorphine (Subutex & Suboxone) partially
Tramadol, MST, Oramorph etc


Benzodiazepines (Valium, Temazepam etc) although these drugs contribute to an overdose effect.
Cocaine & crack
Naloxone is short acting and does NOT get rid of opiate drugs from the body.

Once naloxone wears off, (after about 20-30 minutes) opiates will still be in the body and person may become unconscious/unresponsive again

It is therefore important to phone 999 and request an ambulance as soon as possible

Naloxone will keep someone alive until medical help arrives
Overdose Awareness
Main drugs involved

Physical effects
Risk factors/Causes

High risk times

Signs and symptoms*


Correct actions

Calling 999
Reporting the use of Prenoxad Injection
Give the ambulance crew the used Prenoxad Injection pack


Return the used Prenoxad Injection pack (with needle still attached to syringe) to your local drugs service, or needle exchange

Report the use of Prenoxad Injection to the service that supplied you.

Insist on a re supply!
How/where should it be stored?
Audit Trail/Monitoring
Data set collected for each Prenoxad Injection community pack supply should include;

Permission to collect anonymous data given

Gender,First part postcode/,Patient/client age
GP name and address
Supply to; patient/client, patient/client representative or service worker*

Number of Prenoxad Injection community packs supplied to patient/client
Number of resupplies per patient/client

Reason for resupply?
Audit/Monitoring cont.
If Resupply;
Was medical assistance sought during previous overdose intervention?
Was CPR required/performed?
Outcome of Prenoxad Injection administration/overdose intervention
Prenoxad Injection administered by self (person supplied with Prenoxad Injection community pack)
or other
Ambulance attended scene
Ambulance transport refused
Kit disposal (ambulance, needle clinic, supplying service, pharmacy, other)
Supplying service details:
Training delivered by:
Prenoxad Injection community pack supplied by:

This information should be collected upon each Prenoxad Injection supply.
This information should be reported to the designated 'take home naloxone programme' lead and stored electronically for the purposes
of audit, monitoring, reporting and evaluation of reach and impact of programme
NOTE: Before the training please visit
Please also review
Prenoxad Injction SmPC
Full transcript