How to Use the VA Naloxone Nasal Spray
11
October

By Adem Lewis / in , , /


YEAH. HI, IS ONE OF
YOU MS. HALL? UH, YEAH. THAT’S ME,
BUT PLEASE CALL ME MARTY, AND THIS IS
MY ROOMMATE JEN. HEY. I TOLD CHARLENE I THOUGHT
IT WOULD BE GOOD IF SHE SAT IN. AND I’M HER RIDE ANYWAY,
SO I MIGHT AS WELL LEARN SOMETHING, RIGHT? YEAH. WELL, IT’S NICE
TO MEET YOU BOTH. MY NAME IS JACK CARTWRIGHT,
I’M A CLINICAL PHARMACIST, AND I’D LIKE
TO SHOW YOU HOW TO USE THE NALOXONE NASAL SPRAY
IN CASE OF AN OPIOID OVERDOSE. – IS THAT OK?
– YEAH. – SURE.
– GREAT. WE’RE GOING TO DO
A BIT OF HANDS-ON TRAINING IN A MOMENT, BUT I WANTED
TO MAKE SURE YOU KNEW THAT THIS WASN’T YOUR
ONLY CHANCE TO LEARN EVERYTHING. WE ALSO HAVE WRITTEN
MATERIALS YOU’LL BE ABLE TO TAKE AWAY WITH YOU, AND
WE’RE GOING TO HAVE VIDEOS ONLINE YOU’LL BE ABLE
TO WATCH AT ANY TIME. SO IF YOU’RE CONCERNED
YOU WON’T BE ABLE TO REMEMBER EVERYTHING AFTER YOU
LEAVE HERE TODAY, IT’S OK. THERE ARE LOTS OF WAYS
TO REVIEW THE INSTRUCTIONS AND
INFORMATION LATER. DOES THAT SOUND GOOD? – YEAH.
– SURE. GREAT. OK. SO HERE IS YOUR NALOXONE
NASAL SPRAY, AND, UH, WE’LL GO OVER IT TOGETHER. OK. SO RULE NUMBER ONE–
BRING YOUR NALOXONE NASAL SPRAY WITH YOU
WHEREVER YOU GO. IF YOU’RE DRIVING,
HAVE IT IN YOUR CAR. IF GO INSIDE YOUR HOME,
TAKE IT INSIDE WITH YOU. IF YOU GO ON VACATION,
THEY GO WITH YOU. SO LIKE A DIABETIC WOULD
KEEP HER INSULIN WITH HER. RIGHT. OR AN EPI PEN IF YOU WERE
ALLERGIC TO BEE STINGS. EXACTLY! RULE NUMBER TWO IS DON’T
STORE THE NASAL SPRAY FOR PROLONGED
PERIODS OF TIME IN EXTREME TEMPERATURES. YOU SHOULD AVOID HEAT,
COLD, OR DIRECT SUNLIGHT TO TRY TO KEEP IT
AT ROOM TEMPERATURE. OTHERWISE, THE DRUG
MAY NOT WORK AS WELL. NOW DO YOU REMEMBER WHAT
RULE NUMBER ONE WAS? BRING IT WITH ME! EXACTLY! YOU NEVER KNOW WHEN
YOU MIGHT NEED IT. NOW YOU ALREADY WENT
OVER THE SIGNS OF OPIOID OVERDOSE WITH
CHARLENE, RIGHT? YES. UH, CHECK, LISTEN,
LOOK, AND…TOUCH! SO CHECK FOR DEEP SLEEP. SHAKING WON’T WAKE YOU. LISTEN FOR SNORING THAT
SOUNDS LIKE CHOKING, UH, BREATHING STOPPED, OR
REALLY SLOW, LIKE ONCE EVERY 5 SECONDS. LOOK FOR BLUE OR GRAY LIPS
OR FINGERNAILS… AND TOUCH FOR PALE
OR CLAMMY SKIN. BINGO! SO NOW YOU KNOW WHEN
YOU MIGHT NEED TO USE THE NALOXONE. NOW LET’S MAKE SURE
YOU KNOW HOW TO USE IT. SO WHEN I TALKED TO
CHARLENE, I THOUGHT IT WAS JUST LIKE NASAL SPRAY
YOU GET FOR ALLERGIES OR WHATEVER, BUT SHE
SAID NOT EXACTLY. YEAH, IT’S A LITTLE
MORE TO IT THAN THAT. ALTHOUGH THE POSITIONING
OF THE FINGERS, WHICH WE’LL GO OVER IN A
MINUTE, IS SIMILAR. THERE’S ONE VERY
IMPORTANT DIFFERENCE. YOU SHOULD NOT PRIME OR
TEST THE SPRAY BECAUSE IT ONLY HAS ONE DOSE IN IT. THIS IS REALLY IMPORTANT. – OK.
– OK, YEAH. WHAT’S NICE IS THERE ARE
LOTS OF PLACES TO GET INFORMATION ABOUT
USING THE NASAL SPRAY. IN FACT, THERE
ARE 4 PLACES. IN CASE THE THIRD
TIME’S NOT THE CHARM. STOP. WELL, WE KNOW OVERDOSE
EMERGENCIES CAN BE REALLY SCARY, AND WE WANT YOU TO
KNOW WHAT TO DO EVEN IF YOU’RE FRIGHTENED
AND OVERWHELMED. THAT’S WHY WE DO THESE
SESSIONS AND WHY IT’S HELPFUL TO HAVE
THE INFORMATION IN MULTIPLE PLACES. SO THE 4 PLACES TO
GET THE NASAL SPRAY INSTRUCTIONS ARE: ONE,
RIGHT HERE ON THE BOX ITSELF; TWO, INSIDE THE BOX… RIGHT HERE–THIS ALSO
HAS Q&As, SIDE EFFECTS, AND OTHER PHARMACEUTICAL
INFORMATION; 3, ON THE QUICK START GUIDE,
WHICH IS LOCATED INSIDE OF THE NASAL SPRAY;
AND JUST IN CASE THAT’S NOT ENOUGH INFORMATION, THE
VA’s PUT TOGETHER THIS REALLY EASY-TO-READ
OPIOID OVERDOSE BROCHURE. JEN: THANKS. MARTY: SO, YEAH, LIKE YOU
SAID, A LOT OF PLACES TO GET INFORMATION. – RIGHT.
– MM-HMM. NOW THE VA’s BROCHURE
ISN’T MEANT TO REPLACE THE INSTRUCTIONS THAT COME
IN THE BOX, SO YOU SHOULD DEFINITELY READ
THOSE, TOO. SO NOW THAT YOU KNOW WHERE
THE INSTRUCTIONS ARE, LET’S TALK ABOUT THE
ACTUAL NASAL SPRAYS. IN EACH BOX, THERE
ARE TWO NASAL SPRAYS. NOW THE SPRAYS COME SEALED
IN PLASTIC TO KEEP THEM CLEAN, AND SINCE THESE ARE
YOUR NASAL SPRAYS, WE’RE GOING TO KEEP THEM SEALED,
BUT I’LL WALK YOU THROUGH THE NEXT STEPS. TO OPEN THE PACKAGE, TURN
IT OVER AND FIND THE TAB MARKED WITH A CIRCLE. YOU PEEL IT BACK AND
REMOVE AND REVIEW THE QUICK START
GUIDE RIGHT THERE. NOW I’VE BROUGHT A
DEMONSTRATION DEVICE WE CAN LOOK AT. SO TO USE IT, HOLD THE
SPRAY BY PUTTING YOUR THUMB ON THE BOTTOM OF
THE PLUNGER AND YOUR FIRST AND MIDDLE FINGERS ON
EITHER SIDE OF THE NOZZLE. NOW REMEMBER, DO NOT
PRIME OR TEST THE SPRAY BECAUSE YOU COULD WASTE
THE LIFE-SAVING MEDICATION INSIDE. IT’S SO TINY! LOOK AT THAT. WOW. IT’S AMAZING HOW THIS
COULD SAVE YOUR LIFE. I PROMISE, IT WORKS! NOW TO ADMINISTER THE
MEDICINE, UM–I’LL SHOW YOU IN HERE. MM-HMM. YOU TILT THE PERSON’S HEAD
BACK LIKE THAT, AND YOU WANT TO GIVE SUPPORT AT THE BACK
OF THE NECK WITH YOUR HAND. GENTLY INSERT THE TIP
OF THE NOZZLE INTO THE PERSON’S NOSTRIL UNTIL
YOUR FINGERS ON EITHER SIDE OF THE NOZZLE
TOUCH THE BOTTOM OF THE PERSON’S NOSE. THEN PRESS THE PLUNGER
WITH YOUR THUMB FIRMLY, ALL THE WAY IN TO GIVE
THE FULL DOSE OF NALOXONE. AND HOW DO YOU KNOW
THAT YOU’VE GIVEN THE RIGHT DOSE? ONCE THE PLUNGER WON’T
PUSH IN ANYMORE, YOU’LL KNOW YOU’VE GIVEN THE
FULL AND CORRECT DOSE. JEN: IS IT POSSIBLE
TO GIVE TOO MUCH? YOU DON’T REALLY HAVE
TO WORRY ABOUT THAT. THE SPRAY ONLY CONTAINS
ONE DOSE, AND YOU CAN’T REALLY OVERDOSE ON
NALOXONE ANYWAY. AND ONE DOSE DOES IT? USUALLY, BUT IF THE
PERSON’S STILL SHOWING SIGNS OF OVERDOSE AFTER
2 OR 3 MINUTES OR STOPS BREATHING, WHICH CAN
HAPPEN, THEN YOU GIVE A SECOND DOSE. THAT’S WHY THERE’S
A SECOND NALOXONE SPRAY IN THE KIT JUST IN
CASE YOU NEED IT. YOU’D FOLLOW THE SAME
STEPS AS YOU DID WITH THE FIRST DOSE. IT’S IMPORTANT TO CALL
911 RIGHT AFTER YOU’VE GIVEN THE FIRST DOSE
SO PARAMEDICS WILL BE ON THEIR WAY. WOW. I’M GLAD THAT WE
HAVE THAT SECOND DOSE. MM-HMM. AND I CAN SEE WHY YOU’D
WANT TO CALL 911. YEAH. YOU DEFINITELY
DON’T WANT TO DO THIS ALL ON YOUR OWN. MM-HMM. OK. THE LAST THING I WANT
TO POINT OUT IS WHAT TO DO AFTER YOU’VE USED
THE NASAL SPRAY. ONCE IT’S BEEN USED,
MAKE SURE YOU DISPOSE OF THE SPRAY
IN A SAFE WAY. MAKE SURE YOU THROW IT AWAY
OUT OF REACH OF CHILDREN AS IT SAYS THERE. – GOT IT.
– OK. GREAT. ALSO, IF YOU USE YOUR
NASAL SPRAYS OR IF THEY EXPIRE, IT’S REALLY
IMPORTANT TO LET YOUR PROVIDER KNOW AND
ASK FOR ANOTHER ONE. IF YOU USE THE NASAL
SPRAYS, WE’LL WANT TO CHECK IN TO FIND OUT
WHAT HAPPENED, HOW YOU’RE DOING, AND SEE IF THERE’S
ANYTHING ELSE WE CAN DO TO HELP. WE’LL BE SURE TO SEND YOU
A NEW PRESCRIPTION RIGHT AWAY BECAUSE YOU SHOULD
NEVER BE WITHOUT ONE. ANY QUESTIONS? NO. UH, THAT MAKES SENSE. JUST HOPING I DON’T HAVE
TO CROSS THAT BRIDGE. THAT’S FOR SURE. YEAH, AND WE HOPE SO,
TOO, AND THAT’S WHY THE EDUCATION CHARLENE GAVE
YOU ON HOW TO PREVENT AN OPIOID OVERDOSE
IS SO IMPORTANT. HOPEFULLY YOU WON’T NEED
TO USE THE NASAL SPRAYS, BUT IF AN EMERGENCY DID
HAPPEN, YOU’RE NOW BOTH FULLY TRAINED EMERGENCY
NALOXONE ADMINISTRATORS. THANKS. THANK YOU. GREAT. WELL, IF WE DON’T
HAVE ANY MORE QUESTIONS, I CAN GET THIS STUFF
PACKAGED UP, AND YOU CAN TAKE THAT HOME. I’LL TAKE THIS
BACK. GREAT.


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