Chloe Sage, co-ordinator of harm reduction programming at ANKORS, took a Star reporter through the steps of using a naloxone kit. Photo: Tyler Harper

Chloe Sage, co-ordinator of harm reduction programming at ANKORS, took a Star reporter through the steps of using a naloxone kit. Photo: Tyler Harper

VIDEO: How to use naloxone to stop a fentanyl overdose

ANKORS’ Chloe Sage shows what to do when someone is overdosing

Chloe Sage knows how to use naloxone. She can teach others how to use it. Yet when the time came for her save someone suffering an opioid overdose even she struggled to do it the right way.

Sage is ANKORS’ co-ordinator of harm reduction programming in Nelson. Part of her job is training people in naloxone injections, and that’s easily done in the quiet of her office. But the process can be stressful even in practice, and mistakes are easily made.

Once Sage had to come to the aid of someone overdosing in a car in ANKORS’ parking lot. Usually just one injection is given in the first three minutes, but Sage had to give two shots right away because she forgot the small but crucial step of swirling the naloxone vial first.

“I thought I was giving breaths to a dead person,” she said. “I really did. It was really scary.”

Sage recently took a Star reporter through the step-by-step process of administering naloxone. ANKORS also offers more extensive free training that comes with two naloxone kits.

Related:

Naloxone prevented 26% of possible overdose deaths in B.C.: study

Parents call for change to health laws after Victoria teen’s death

WATCH: Moms Stop The Harm respond to opioid crisis

What is naloxone?

Naloxone is a medicine that temporarily strips opioids from receptors in the brain. Overdoses occur when too much opioid is on the receptors.

What are signs of an overdose?

There are two types of overdoses, but only one that can be treated with naloxone.

Stimulant overdoses, which occur with drugs such as cocaine, methamphetamine and ecstasy, causes a person to be hot, agitated, hyperactive and sweat. The person also may have a high heart beat and fast breathing.

Naloxone doesn’t work on stimulant overdoses, but can be used anyway on the off chance the person has mixed in an opioid with the stimulants. Because it’s harmless, naloxone can be injected without concern of side effects.

Naloxone is used to treat opioids such as heroin, morphine and fentanyl. Symptoms of an opioid overdose include drowsiness, nodding off, slow or no pulse, blue lips and/or nails, cold skin, vomiting, slow or no breathing, or gurgling sounds that come from the lungs struggling to take in air.

It’s crucial to know that naloxone is not a cure. When it works, it temporarily removes opioids from receptors in the brain for approximately 30-to-75 minutes.

“So that’s where it’s really important to stay with a person even after you’ve given them naloxone and they’ve woken up and they seem like they are actually fine,” said Sage. “Many people have died that way. You send them home and they re-overdose.”

The inside of each naloxone kit includes the SAVE ME steps, which stand for stimulation, airway, ventilation, evaluate, muscular injection and evaluate and support.

Stimulation: If a person is suspected of having an overdose, first try to wake them by yelling, rubbing knuckles hard on their sternum, or squeezing their neck like Spock’s Vulcan nerve pinch. If that doesn’t work, call 911.

Airway: Brain damage occurs after five-to-seven minutes with a lack of oxygen and, depending on location and traffic, paramedics may not arrive prior to then. Check the person’s airway to make sure they are breathing, and that their chest is rising and falling. If they aren’t, that leads to the next step.

Ventilation: Lay the person out flat and tilt their head up. Each naloxone kit includes a mouth guard, which can be placed over the person’s face. The person’s jaw may need to be pried open to insert the guard.

Pinch their nose and give them two quick breaths, then one every five seconds. Count out loud to five throughout the entire injection process. This needs to be continued until the person is revived.

“A lot of people think naloxone is the thing that saves the life. It’s actually breaths and naloxone,” said Sage.

Evaluate: Take a moment to check if they are breathing on their own. If not, grab the syringe and a vial from the kit.

Muscular injection: Give the vial a quick swirl to make sure it is all at the bottom. The kit also comes with a plastic top that be put on top of the vial and snapped to protect your hand from glass.

Take the syringe and draw out all the naloxone from the vial. Don’t worry about air in the syringe as the injection is going into a muscle and not a vein.

Pinch either the thigh, arm or butt and jab the syringe in through the clothes. Slowly inject all the way until you hear a click, which is the needle retracting all the way back into the syringe.

Set a timer for three minutes and continue to give breaths every five seconds. If the naloxone works, the person will sit up and take a deep breath. Tell them to keep breathing, who you are and where they are. They might be angry, distressed or in pain, so try to keep them calm.

If, however, nothing has happened after three minutes then give them another injection and reset the timer.

“If they wake up and they start breathing again and you’re seeing they are alert, you don’t need to give them another vial of naloxone,” said Sage. “But fentanyl is so strong now that people are saying it took five vials of naloxone to bring them back. So a lot of people are doing two shots of naloxone immediately.”

Evaluate and support: If the person is breathing on their own, tell them not to use any more drugs for the time being, that they could re-overdose, and that you will stay with them for at least two hours or until paramedics arrive. If they nod off again and paramedics haven’t arrived, give them another injection.

Keep the naloxone at room temperature and replace it after two years.

More information can be found at http://towardtheheart.com/naloxone.



tyler.harper@nelsonstar.com

Like us on Facebook and follow us on Twitter

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Calls for potential overdoses in B.C. spiked in 2020, especially in the Okanagan - Shuswap. Pictured above is a BCEHS re-enactment of paramedics attending an overdose. (BCHES photo)
UBCO program increases drug checking availability in Kelowna, Penticton, Vernon

January 2021 data shows of 95 opioid samples tested across Interior Health, 93 contained fentanyl

Person experiencing homelessness. (Black Press Media file photo)
Program preventing youth homelessness launches in Kelowna

Upstream Project’s goal is to help young people become more resilient

Youth from Vernon, Kelowna, Penticton and the Kootenays were able to dig into two evenings of online learning and connection through United Way Southern Interior B.C.’s <CODE>anagan program. (Submitted)<code> </code>
CODEanagan gives youth a chance to learn about technology

The youth, aged 12 to 21, built their own WordPress sites and developed blogging ideas

A rainbow shining on Kelowna General Hospital on May 12, 2020 International Nurses Day. (Steve Wensley - Prime Light Media)
New COVID cases trending down in Interior Health

24 new cases reported Thursday, Feb. 25, death at Kelowna General Hospital

The Combined Forces Special Enforcement Unit of British Columbia’s (CFSEU-BC) Uniform Gang Enforcement Team (UGET) has arrested a man who was on the run for nearly a decade. (File photo)
9-year search for international drug trafficking suspect ends with arrest at YVR

Khamla Wong, charged in 2012, taken into custody Feb. 24 by BC-CFSEU

Provincial health officer Dr. Bonnie Henry updates B.C.’s COVID-19 situation at the B.C. legislature. (B.C. government)
B.C. reports 10 additional deaths, 395 new COVID-19 cases

The majority of new coronavirus infections were in the Fraser Health region

A new survey has found that virtual visits are British Columbian’s preferred way to see the doctor amid the COVID-19 pandemic. (Unsplash)
Majority of British Columbians now prefer routine virtual doctor’s visits: study

More than 82% feel virtual health options reduce wait times, 64% think they lead to better health

Larch Place is the first building to be built in the BC Housing, Canadian Mental Health Association housing project at the corner of Third Street SW and Fifth Avenue SW. This view is from the Shuswap Street side where it sits behind the Graystone East building. (File photo)
Opening of doors at new housing development in Salmon Arm welcomed

BC Housing announces opening of 32 rental units, with 35 more expected in summer 2021

Cory Mills, Eric Blackmore and A.J. Jensen, all 20, drown in the Sooke River in February 2020. (Contributed photos)
Coroner confirms ‘puddle jumping’ in 2020 drowning deaths of 3 B.C. men

Cory Mills, Eric Blackmore and A.J. Jensen pulled into raging river driving through nearby flooding

Castlegar doctor Megan Taylor contracted COVID-19 in November. This photo was taken before the pandemic. Photo: Submitted
Kootenay doctor shares experience contracting COVID-19

Castlegar doctor shares her COVID experience

Vancouver International Women in Film Festival kicks off March 5.
Women in Film Festival features two B.C. filmmakers

The 16th annual festival kicks off March 5, 2021

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

The booklet roots present day activism in the history of racist policies, arguing the history must be acknowledged in order to change. (CCPA)
New resource dives into 150 years of racist policy in B.C.

Racist history must be acknowledged in order to change, authors say

Agatha Mary Clarissa Miller, before she knew she would change literature. Photo Wikipedia
And Then There Were None

What book knocked your booties off when you were young?

Most Read