1. Step 1: Get Help Call 911 Tell them you have a friend who is not breathing. Make sure EMS has a clear path to get to you, and doors are unlocked. Give clear directions. Step 1

2. Step 2: Rescue breathing Step 2

3. Instructions for rescue breathing Put the facemask, found in your rescue kit, on the victim’s face Tilt victim’s head back, make sure nothing is blocking the airway, and pinch nose Give 2 quick breaths and count to 5 Give 1 long breath Continue giving 1 breath every 5 seconds Step 2

4. If you are trained to give CPR, do it. Do not give rescue breathing If you are trained to give CPR, for Step 2, give CPR instead of rescue breathing. Remember: 1 round of CPR = 2 breaths 30 compressions Step 2

5. Rescue breathing or CPR Sometimes, the victim may wake up just from the oxygen alone. If so, do not continue to Step 3. Step 2

6. Step 3: Administer naloxone Step 3

7. Administering naloxone Nasal: Spray half of the vial of naloxone into each nostril Injectable: Inject the entire vial into the upper arm or thigh Continue rescue breathing (or CPR, if you’re trained) as needed If the person doesn’t respond to 1st vial of naloxone, wait 2-5 minutes and give the 2nd vial Step 3

8. Naloxone (Narcan) Reverses temporarily opiate effect of sedation and respiratory depression Takes effect within 2 - 8 minutes Causes sudden withdrawal in the opioid dependent person – an unpleasant experience Can’t get high from it Has no effect if an opiate is not present Routinely used by EMS (but in larger doses) Step 3

9. After naloxone is given: Awake and breathing Naloxone/Narcan wears off in 30-90 minutes Reassure the victim if s/he is feeling dope-sick – the naloxone will wear off. Using more drugs won’t have any effect while naloxone present. Instruct victim to go to the hospital with EMS for monitoring. Step 3

10. If the victim starts breathing place her/him in the recovery position to prevent choking on vomit. Recovery Position