Lay rescuers should not wait for naloxone to take effect before activating 911 in patients suspected of opioid overdose.
Trained EMS responders when treating an opioid overdose patient in suspected cardiac arrest should focus on high quality CPR (compressions plus ventilations) before considering the use of naloxone.
These are two recommendations from the American Heart Association’s latest 2020 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care released this morning.
2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Here is a key line: Because there are no studies demonstrating improvement in patient outcomes from administration of naloxone during cardiac arrest, provision of CPR should be the focus of initial care. Naloxone can be administered along with standard ACLS care if it does not delay components of high-quality CPR.
Whether you are a lay person or a professional providers, for suspected opioid overdose patients without a pulse, CPR is of the utmost priority.
Naloxone does not bring patients back from the dead. It will bring back people in respiratory arrest. Once their heart has stopped, the patient needs quality CPR (and possibly epinephrine).
Here’s a blog I wrote in 2017 about this topic:
Naloxone in Cardiac Arrest