Toxicology: Opioid Overdose

Key Points/Considerations
• Only administer Naloxone to suspected opiate overdoses with hypoventilation.
For provider and patient safety, do not administer if there are adequate
ventilations without physician order
• ALS providers should titrate Naloxone dose to respiratory rate
• If suspected narcotic overdose, providers may administer Naloxone prior to
checking blood glucose level
• Do NOT give Naloxone (Narcan) to any patient who is intubated without physician
order unless they are in cardiac arrest
• If suspected isolated opiate overdose, please consider giving Naloxone intranasally
for provider safety

Toxicology: Overdose or Toxic Exposure

Key Points/Considerations
• Dystonic reaction is uncontrolled muscle contractions of face, neck or tongue
• See also: Opiate Overdose, Organophosphate Exposure, Suspected Nerve Agent

Toxicology: Organophosphate Exposure

Key Points/Considerations
• If suspected WMD refer to Medical: Suspected Nerve Agent or NYS Advisory on
Mark 1 Kits, #03-05

Toxicology: Suspected Nerve Agent

Key Points/Considerations
• EMS providers should be trained at the WMD Awareness level to use this protocol
• The auto-injectors or other medications found in the EMS CHEMPACK are NOT
to be used for self-administration or prophylaxis
• Children should be decontaminated and have expedited transport off scene
especially if they are demonstrating ANY signs and symptoms of exposure
• Consult physician before administering medication to children less than 8 years old
• CHEMPACK medications may be used regardless of expiration date

 Toxicology: Suspected Nerve Agent
THIS PROTOCOL IS SPECIFIC TO A DISASTER SETTING

Key Points/Considerations
• EMS providers should be trained at the WMD Awareness level to use this protocol
• The auto-injectors or other medications found in the EMS CHEMPACK are NOT
to be used for self-administration or prophylaxis
• Children should be decontaminated and have expedited transport off scene
especially if they are demonstrating ANY signs and symptoms of exposure
• Consult physician before administering medication to children less than 8 years old
• CHEMPACK medications may be used regardless of expiration date

• ChemPack Assets: Valium, Atropine & Pralidoxime [2PAM CL] may be
administered by qualified emergency personnel and designated emergency
responders who have had adequate training in on-site recognition and treatment of
nerve and/or organophosphate agent intoxication
• Valium auto-injectors should be administered as directed on packaging only to
patients who are having active tonic-clonic seizures