51950253.pdf

\n\n--- Page 1 ---\n\nSEMINOLE COUNTY SHERIFF'S OFFICE NUMBER: G - 66 GENERAL ORDER RESCINDS: SUBJECT: Emergency Treatment for Suspected Opioid Overdose EFFECTIVE: November 1, 2016 REVISED: February 10, 2023 Table of Contents: I. Purpose II. Policy III. Definitions IV. Procedures V. Program Coordinator I. PURPOSE: The purpose of this general order is to establish guidelines and regulations governing administering an emergency opioid antagonist into a person’s body by trained personnel within the Seminole County Sheriff’s Office. The objective is to reduce fatalities due to opioid-involved overdoses when Seminole County Deputy Sheriffs or other agency first responders are the first to arrive at the scene of a suspected overdose. II. POLICY: Seminole County Sheriff’s Office personnel may possess and administer an emergency opioid antagonist so long as they have been trained consistent with Florida Statute 381.887. Seminole County Sheriff’s Office policy and training curriculum comply with Florida Statute 381.887, which provides civil immunity for first responders or non-medical persons, from liability when administering an emergency opioid antagonist to reverse an opioid overdose. III. DEFINITIONS: A. Opioid: An opioid is a medication or drug derived from the opium poppy or that mimics the effect of an opiate. Opiate drugs are narcotic sedatives that depress the activity of the central nervous system; these will reduce pain, induce sleep, and in overdose, will cause people to stop breathing. First responders often encounter opiates like morphine, methadone, codeine, heroin, fentanyl, oxycodone (OxyContin® and Percocet®), and hydrocodone (Vicodin®). B. Emergency Opioid Antagonist: It is Naloxone hydrochloride, Kloxxado® or any similarly acting drug. It is a prescribed medication that can be used to reverse the effects of an opiate overdose. Specifically, it displaces opioids from the receptors in the brain that control the central nervous and respiratory systems. It is GENERAL ORDER Emergency Treatment for Suspected Opioid Overdose G-66 Page 1 OF 5\n\n--- Page 2 ---\n\nmarketed under various trademarks, including Narcan® or Kloxxado®. It provides only temporary reversal; therefore, it is not a substitute for emergency medical care. C. Naloxone/Narcan® or Kloxxado® Nasal Spray: A medically approved emergency opioid antagonist delivery system that delivers Naloxone hydrochloride or similarly acting drug by means of nasal passage delivery (IN), as approved by the Seminole County Medical Director. D. Patient: A patient as encountered by a first responder means a person at risk of experiencing an opioid overdose. E. Emergency Opioid Antagonist Program Coordinator: The Sheriff will designate a sworn Manager at the Lieutenant’s level as the Program Coordinator. F. First Responder: Deputy sheriffs and other agency personnel as indicated by Florida Statutes or agency policy, who by nature of the assignment, are required to respond to calls for service or provide investigative services, supervision and/or care for persons on probation or community control. When direct contact with such individuals creates the necessity to evaluate a possible overdose or poses a threat of exposure to the first responder from an opioid substance through contact with the individual or their surroundings. IV. PROCEDURES: A. Emergency Opioid Antagonist Administration: 1. Seminole County Deputy Sheriff’s assigned to the Department of Neighborhood Policing in the role of a first responder will have an emergency opioid antagonist delivery system, hereinafter referred to as Naloxone, or Narcan Nasal Spray on their person, available for immediate administration. Other Sheriff’s Office personnel may be equipped with Naloxone Nasal Spray as deemed necessary by the Program Coordinator. 2. In the event a First Responder arrives first at the scene of a suspected overdose, the First Responder will immediately request Fire/EMS services to respond to the scene where the patient is in a potential overdose state. 3. First Responders should use universal precautions and protections (PPE) from blood borne pathogens and communicable diseases when using Naloxone Nasal Spray. 4. First Responders will determine the need for treatment with Naloxone by evaluating the patient for responsiveness, pulse and breathing status, considering all additional information known at that time. 5. If the patient is unresponsive without respirations and no pulse, CPR should be considered as the primary means of first responder care. If the breathing of the patient becomes adequate and the patient has regained a pulse, then the patient should be placed in the recovery position and breathing and pulse should be monitored for deteriorating status until Fire/EMS arrives. 6. If the patient is unresponsive with decreased or absent respirations, the First Responder should administer Naloxone following the established training guidelines. This should only be done if administering Naloxone would not cause undue delay in providing rescue CPR. GENERAL ORDER Emergency Treatment for Suspected Opioid Overdose G-66 Page 2 OF 5\n\n--- Page 3 ---\n\n7. If the first responder determines that for reasons of officer safety or if deployment of the Naloxone Nasal Spray would cause undue delay for providing rescue CPR then the first responder should proceed with CPR first and wait for the arrival of a second responder before administering Naloxone Florida Statute 381.887 does not create a duty or standard of care for a person to administer Naloxone 8. First Responders will use proper tactics, ensuring that weapons, or items that can be used as weapons, are not within reach of the patient when using the nasal spray as patients who are revived from an opioid overdose may regain consciousness in an agitated or combative state and may exhibit symptoms associated with acute withdrawal. Non-sworn personnel should wait for the assistance of a Deputy Sheriff if the scene is deemed too dangerous to enter. 9. If the patient responds to the administration of Naloxone and there is no evidence of trauma, then the patient should be placed in the recovery position until EMS arrives on scene to assume control of the patient. If the patient has not responded to the administration of Naloxone/ after 3-5 minutes, then a second dose of Naloxone may be repeated, if available. 10. Should the administration of Naloxone not work and the patient is still unresponsive without a pulse, then first responders should continue to rescue CPR and/or use of an AED, until EMS personnel arrive. They will remain with the patient until transport or if requested by EMS personnel. 11. First Responders will inform EMS personnel upon their arrival, that 8mg or 4mg Naloxone Nasal Spray has been administered and its efficacy. 12. First Responders will notify their supervisor of the use of Naloxone and document its use in the appropriate Cafe Report, describing the nature of the incident, including the extent of care the patient received. UCR Code 9037 shall be used for successful deployments of Naloxone and a UCR Code of 9038 shall be used for unsuccessful deployments of Naloxone. This documentation supports the annual report indicating success rates, which is provided to the Seminole County Medical Director and the Department of Health. 13. Used Naloxone Nasal Sprays should be turned over to EMS personnel at the scene for proper disposal in their medical waste bag on each rescue or engine. NOTE: When a First Responder administers Naloxone/ that results in a resuscitation of an overdose victim, he/she will consult with on scene Fire/EMS personnel and rely on their assessment to ensure the patient receives appropriate follow-up care. The effects of Naloxone are temporary and the person may experience another opiate overdose when the medication wears off. As such, every effort, in collaboration with Fire/EMS personnel, should be made to encourage that person to be transported to the hospi