ADMINISTRATION OF NALOXONE (NARCAN)

ADMINISTRATION OF NALOXONE (NARCAN)

ag5330BAdopted December 5, 2023

5330B - ADMINISTRATION OF NALOXONE (NARCAN)

Board Policy 5330 and the procedures on the administration of medication in AG 5330 must be observed at all times.

Purpose

The School District of Jefferson (SDOJ) wishes to prevent opiate-related overdose deaths by making Naloxone available in the schools. Naloxone (also known as Narcan) is a medication found to reverse the effects of an opiate-related drug overdose. 2017 Wisconsin Act 29 permits trained school bus operators, employees, or volunteers to administer an opioid antagonist (i.e., Naloxone/Narcan) to pupils and other persons who appear to be undergoing an opioid-related drug overdose.

Medical Advisor Standing Order

The School Nurse or designee shall obtain a standing medical order from the SDOJ medical advisor who will authorize the school district to obtain, store and administer Narcan, by authorized school personnel, to any individual suspected of experiencing an opiate-related overdose while at school. The standing order shall be maintained in the School Nurse office and copies of the standing order shall be kept in each location where the Narcan is stored.

Training

Members of the Medical Emergency Response Team (MERT) in each building and the School Nurse will be trained to administer Narcan. Before being authorized to administer Narcan, individuals must:

Complete the Wisconsin DPI approved medication training program that includes recognizing opioid related overdoses, administering Narcan, and promptly activating the emergency medical system for drug overdoses.

A list of SDOJ individuals who have successfully completed the training will be maintained by the School Nurse.

PROCEDURES

  1. Recognize the signs of an overdose:
     
    1. Pale, clammy skin
    2. Not breathing or very shallow breathing
    3. Deep snorting or gurgling
    4. Unresponsive to stimuli (calling name shaking, sterna rub)
    5. Slowed heart beat/pulse
    6. Blue lips or fingertips
    7. Pinpoint pupils
  2. Respond:
     
    1. Immediately call for help – dial 911 (request advance life support)
    2. Place the person on their back
    3. Tilt head
    4. Lift chin
    5. Check for breathing for no more than ten (10) seconds
    6. Check to see if there is anything in their mouth blocking their airway (e.g., gum, tooth pick, undissolved pills, syringe cap, cheeked Fentanyl patch)

      If present, remove it
    7. If no breathing or shallow breathing, begin rescue breathing or CPR using a barrier mask
    8. Give two (2) even, regular-sized breaths
    9. Blow enough air into their lungs to make their chest rise. If you don’t see their chest rise out of the corner of your eye, tilt the head back more and make sure the seal around the mouth and nose is secure.

      If you don’t see their chest rise out of the corner of your eye, tilt the head back more and make sure the seal around the mouth and nose is secure
    10. Breath again
    11. Give one (1) breath every five (5) seconds
  3. Reverse – Administer Intra-Nasal Narcan:
     
    1. Tilt head back and give spray (4 mg) into one (1) nostril
    2. Move the person onto their side (recovery position) and monitor until EMS arrives
    3. If the person does not respond by waking up, to voice or touch, or breathing normally, another dose may be given. Narcan nasal spray may be dosed everytwo (2) to three (3) minutes, if available
    4. Repeat the above steps using a new Narcan nasal spray to give another dose in the other nostril. If additional Narcan nasal sprays are available, the above steps may be repeated every two (2) to three (3) minutes until the person responds or emergency medical health is received
    5. Seize all illegal and/or non-prescription opioid narcotics found on the victim and give them to EMS along with used Narcan
    6. School Nurse and/or site Administrator will be notified of any administration of Narcan by trained SDOJ staff
  4. Refer:
     
    1. Have the individual transported to the nearest medical facility, even if symptoms seem to get better
    2. If victim is a student, contact parent/guardian per school protocol
    3. MERT member to complete the medical emergency response form and submit to School Nurse
    4. If victim is a student, follow up with treatment referral recommendation
  5. Additional Considerations:
     
    1. The victim may be angry or combative when he or she wakes up, therefore, it is important to stand back from the victim and, if possible, have a second adult present
    2. Potential adverse effects include nausea, diarrhea, abdominal cramping, irritability, restlessness, muscle or bone pain, tearing or nose running, and craving of an opioid
    3. Narcan wears off in thirty (30) to ninety (90) minutes

PROCUREMENT

The medication will be acquired through a written prescription from the SDOJ medical advisor in accordance with Section 441.18 or 448.037 of the State Statutes. The Narcan will be administered under the standing order from the SDOJ medical advisor.

STORAGE

The Narcan will be stored in an unlocked medication cabinet in each school’s main office.

© School District of Jefferson