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Adult Opioid-Associated Emergency Algorithm for Lay Rescuers

Due to the large amount of important information contained in our algorithms, a printable PDF download link is available below.

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Algorithm at a Glance

  • The lay rescuer identifies when an individual may have an opioid overdose.
  • In cardiac arrest, the rescuer begins high-quality CPR while waiting for a defibrillator/AED and naloxone.
  • Naloxone is administered as soon as it is available and then every4 minutes as needed.
  • CPR and monitoring are maintained continuously.

Related Video – Understanding the Opioid-Associated Emergency Algorithm for Lay Rescuers


Goals for the Management of Opioid Overdose in Adult Patients

The lay rescuer will be able to:

  • Recognize an opioid-associated life-threatening emergency
  • Provide appropriate treatment for an opioid-associated emergency

Adult Opioid Algorithm for Lay Rescuers Explained

This algorithm was created to present the steps to guide a lay rescuer in managing victims presenting with symptoms of an opioid overdose.

Box 1: The Patient is Assessed and EMS Activated

If outside of the hospital, the responder calls for help and sends someone for an AED and naloxone. The
responder observes the patient’s respiratory status.

Layperson recognize if individual has opioid overdose.

A layperson will need to recognize if an individual has an opioid overdose.

Box 2: Is the Patient Breathing Normally?

If the patient is breathing normally, the rescuer proceeds to Box 3. If breathing is NOT normal (gasping or no breathing), they proceed to Box 5.


Related Video – Understanding Agonal Breathing


Box 3: Supporting the Patient

The responder maintains an open airway and prepares for transport to the emergency department. Naloxone administration should be considered if available.

Box 4: Continuous Monitoring

The rescuer continues to assess the patient’s breathing and level of consciousness until EMS arrives for transport.

Box 5: Does the Patient Have a Pulse?

The layperson rescuer does not check for a pulse. If the patient is not breathing, the rescuer provides high-quality CPR and administers naloxone when available. If not trained to provide rescue breaths, the lay rescuer performs hands-only CPR and uses the AED when available

Naloxone is available in different forms.

Naloxone is available in different forms, including a nasal spray.

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