CINCINNATI POLICE DIVISION WEEKLY TIME REPORT



NASAL NARCAN INJECTOR USE

Reference:

Ohio Revised Code 2925.61 – Lawful Administration of Naloxone

Ohio Revised Code 4729.51 – Selling, Purchasing, Distributing, or

Delivering Dangerous Drugs

Ohio Revised Code 5122.10 – Emergency Hospitalization

Procedure 5.10 - Handling Suspected Mentally Ill Individual and

Potential Suicides

Procedure 5.20 - Emergency Medical Service, Panic, Duress Alarms,

911 Disconnect Calls, 911 Silent Calls and

Forced Entries

Procedure 6.60 - Bloodborne Pathogens

Procedure 8.11 - Prisoner: Securing, Handling and Transporting

Colerain Township Department of Fire and EMS – Law Enforcement Officer Use of Nasal Narcan Instructional Presentation



Ohio House Bill 170: The bill grants immunity from administrative action and criminal prosecution for the unauthorized practice of medicine and certain drug offenses to a peace officer who does all of the following: (1) Acts in good faith; (2) Obtains naloxone from a law enforcement agency licensed as a terminal distributor of dangerous drugs that employs the peace officer; (3) Administers naloxone to an individual who is apparently experiencing an opioid-related overdose.  

Definitions:

Opioid – Any morphine-like synthetic narcotic that produces the same effects as drugs derived from the opium poppy (opiates), such as pain relief, sedation, and respiratory depression.

Naloxone Hydrochloride (Narcan) – An opioid antagonist for reversal of respiratory depression and other opioid effects in persons who have abused heroin, morphine, or other synthetic opioids. It is a colorless and odorless liquid.

Nasal Narcan Injector Kit – Consists of the Narcan medication, atomizer and instructions for administering Narcan.

Purpose:

To establish Department policy and procedures governing the utilization of Nasal Narcan, administered by employees of the Colerain Police Department. The objective is to reduce fatal opioid overdoses and comply with Ohio House Bill 170.

Policy:

All Police Department employees and reserve corps members will be trained in the use of the Nasal Narcan Injector. All on-duty patrol officers and administrative staff will carry or have ready at hand the Nasal Narcan Kit, inside their police cruiser or available in the building office. Nasal Narcan Injector kits will not be stored inside police vehicles, due to the fluctuation of temperatures and the potential damage to the medicine.

Information:

Naloxone was approved by the Food and Drug Administration in the 1970’s and is a safe medication. Naloxone administration may result in rapid opioid withdrawal, which could cause anxiety and flu-like symptoms. When victims experience these symptoms, they may become irritable and anxious.

The shelf life of Naloxone is approximately two years. Nasal Narcan issued to police officers and staff should be at least nine months, preferably, 12 months from its expiration date. Naloxone should be kept out of direct light, and at room temperature (between 59 and 86 degrees Fahrenheit).

Ohio Revised Code (ORC) 2921.61 (D) grants immunity from administrative action and criminal prosecution to a peace officer who acts in “good faith,” administers Naloxone to an individual who is apparently experiencing an opioid related overdose and obtains Naloxone from the peace officer’s law enforcement agency.

ORC 4729.51 states a terminal distributor of dangerous drugs license is not needed by an officer’s law enforcement agency for the drug Naloxone and permits the agency to purchase Naloxone.

The Ohio Attorney General’s Office website indicates persons administered Nasal Naloxone are less combative than those persons administered Naloxone intravenously.

When an officer has reason to believe a subject has intentionally overdosed, or the subject makes a statement that they meant to harm themselves, the officer will complete the Ohio Departmental of Mental Health Application for Emergency Admission form. The officer will follow procedure 5.10, “Handling Suspected Mentally Ill Individual and Potential Suicides.” The Colerain Township Department of Fire and EMS will transport the person to the appropriate hospital, based on the age of the victim, for treatment of the overdose.

The Colerain Police Department, Property Room Manager will ensure the Nasal Narcan Injector kits are stored safely, according to manufacturer’s guidelines and an adequate supply is maintained to meet the projected demand. Additional doses will be secured inside a locked cabinet, inside the Police Department Property Room.

Procedure:

A. Use of Nasal Narcan Injector Kit

1. Officers and staff will administer Nasal Narcan:

a. In accordance with Colerain Police Department and Colerain Township Department of Fire and EMS training and procedure

b. When dispatched by the Hamilton County Communications Center (HCCC) or notified by Colerain Police Department staff, or receiving knowledge of an overdose upon arrival at a call for service, or while on patrol and notified by another person

1) Signs and symptoms of an Opioid overdose

a) Pinpoint pupils

b) Slow or absent pulse

c) Blue skin tint

d) Limp body and a pale face

e) Vomiting

f) Loss of consciousness

g) Choking; gurgling or snoring sounds

h) Slow or stopped breathing

c. Directions for Use of Nasal Narcan Injector

1) Officers and staff will wear appropriate hand protection (nitrile gloves are recommended)

2) Remove the two pieces of Naloxone syringe from the box

3) Remove the flat purple cap and flat yellow cap from the ends of the Naloxone syringe pieces

4) Connect the two syringe pieces with three (3) half turns

5) Remove the pointed yellow syringe cap

6) Connect the Mucosal Atomization Device (MAD) Nasal atomizer clear end onto the end of the Naloxone syringe

7) Place the white cone end of the syringe in a nostril

8) Dispense 0.5 mg (0.5ml) into each of the victim’s nostrils. Total initial dose will be 1mg (1ml).

9) Initiate rescue breathing, if applicable and equipped

10) The above process may be repeated with the same Naloxone syringe if the person does not wake or have improved signs as defined in (A) after four (4) minutes.

11) The above process may be repeated with a second Naloxone syringe if the person does not wake after four (4) minutes

12) Place the person on their left side

13) Continue to render first aid, until relieved by Colerain Township Department of Fire and EMS personnel or another mutual aid community EMS personnel

B. Transportation of Overdose Victims

1. The administering officer will advise the HCCC that

the person is a potential overdose and Nasal Narcan has been administered

2. HCCC dispatchers should notify responding EMS personnel that the officer is administering Nasal Narcan

3. Persons administered Nasal Narcan who agree to medical treatment will be transported by the responding EMS transport personnel

4. If the person refuses medical treatment or transportation to the hospital and no criminal charges will be signed:

a. This ends the law enforcement responsibility for the immediate response to the overdose incident

5. Upon the arrival of the Colerain Township Department of Fire and EMS units, the Fire Department “General Order and Guidelines” become the operating guidelines for all life safety actions

6. Physical Arrest of Overdose Person

a. All persons will be evaluated by Colerain Township

Department of Fire and EMS personnel, prior to

removal from the scene

b. If there is evidence of a crime or open

warrants/capiases, officers will physically arrest

the person and sign the appropriate charges

c. Colerain Township Department of Fire and EMS will transport the prisoner to University Hospital for treatment of the drug overdose

1) An officer will ride in the ambulance with all arrested persons

d. Reference procedure 8.11 - Prisoner: Securing,

Handling and Transporting

C. Documenting the Use of the Nasal Narcan Injector Kit

1. The use of the Nasal Narcan Injector and, transportation to the hospital will be documented through the use of an “incident” report in the PAMET records management system

2. All “Use of Nasal Narcan” incident reports will be forwarded onto the Colerain Township Department of Fire and EMS, CQI (Quality Control) Coordinator, on a monthly basis

a. The monthly report will be compiled and forwarded onto the Fire Department CQI Coordinator and the Police Department commanders before the 7th day of each month

D. Maintenance and Replacement

1. Officers and staff will conduct an inspection of the assigned Nasal Narcan Injector Kit prior to each work shift

2. Missing, damaged, unserviceable and expired Nasal Narcan Injector Kits will be reported to the officers/staff immediate supervisor

a. The supervisor will notify the Administrative

Lieutenant via email. The email will describe the

circumstances of the missing, damaged and

unserviceable injector kit

b. The Administrative Lieutenant will coordinate the kit replacement with the Property Room manager

c. The damaged and unserviceable kit may be disposed of in any Township waste receptacle

d. Expired Nasal Narcan kits will be given to Colerain Township Department of Fire and EMS

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