Transcript Grampian Naloxone Train the Trainer Quiz - Hi

Grampian Naloxone Programme
“Train the trainer” Training Day
Answers to Quiz
1. Approximately how many drug related
deaths were there in Grampian in 2011?
 B.

50
Drug related deaths fluctuate on an annual
basis and can appear to vary depending on
the report read. On an average year
Grampian accounts for around 10% of all
Scottish deaths meaning there are around
400-500 lives that could be saved in
Scotland each year if somebody present had
access to a supply of naloxone.
2.
Other people/witnesses are not normally
present at overdoses.
 B.

FALSE
It is more common that other people will be
present at the scene when a person
overdoses. This means that there is the
perfect opportunity for people to intervene to
save a life.
3. Older drug users are at higher risk of
overdose.
 A.
TRUE

In 2011 around 70% of drug deaths involved
experienced drug users who had been taking drugs
for 6 years or more as opposed to opioid naïve
individuals who were new to drug taking.

In addition people who have a history of non-fatal
overdose are at increased risk of fatal overdose
4.
Which individuals are eligible to receive
BLS/naloxone training?
 D.

All of these people
There should be no exclusion criteria to anyone
receiving Basic Life Support and naloxone training.
Anybody at risk of overdose or in contact with those at
risk of overdose may be trained. This includes those
prescribed methadone or Suboxone/Subutex etc at
any stage in their treatment. (Remember postdetoxification is one of the high risk times for
overdose.) Friends/family members may hold a
supply on behalf of someone at risk with their
consent. Services in contact with those at risk may
also hold a supply for staff use. At present a supply of
naloxone can only be made to those over 16 years.
5. What is the main body function affected by
opioid overdose?
 B.

RESPIRATION
CNS depressants such as opioid
drugs severely depress the respiratory
system. For this reason rescue
breaths are recommended for opioid
overdose in order to try and get some
oxygen back into the blood.
6. List the four drugs most commonly
involved in opioid overdose
METHADONE
 HEROIN
 DIAZEPAM (BENZODIAZEPINES)
 ALCOHOL


Each of these drugs is classed as a depressant drug.
Mixing combinations of these drugs is one of the most
common causes of overdose. Naloxone will only reverse
the effects of opioid drugs such methadone and heroin.
7. List 3 potential signs that somebody is
experiencing an overdose
Unresponsive/unconscious
 Laboured/reduced breathing
 Blue lips
 Pale, clammy skin

NB: Pinpoint pupils may be present however
this is merely a sign that opioids have been
ingested and are not classed as a clear sign of
overdose.
8. Name the two main risk factors for
overdose
 Reduced
tolerance
 Poly-drug use
9. Name two high risk times for overdose
Any 3 of the following:







On release from prison
On leaving residential rehabilitation or hospital
On recent detoxification
During period of relapse
After a recent life event (bereavement, relationship
breakdown etc)
During festive periods, weekends & holidays
Any others?
10. List 3 ‘myths’ for dealing with an overdose
casualty
Any 3 of the following:







Walking the casualty around (risk of further injury)
Inflicting pain (will not work on someone unconscious or
who has taken a strong painkiller such as heroin)
Injecting stimulant drugs (stimulant drugs cannot
counteract or reverse effects of opioid overdose)
Injecting salty water (there is sometimes (client)
confusion that this is similar to a hospital saline drip)
Throwing water or put casualty in bath / shower (trigger
shock or accidental drowning)
Putting the casualty outside (risk of hypothermia)
Any others?
11. Cocaine use increases the risk of fatal
overdose
TRUE
Using stimulants will put additional pressure on
the heart by increasing heart rate, therefore
increasing the risk of cardiac arrest
12. Name the group of drugs which can be
reversed by naloxone
OPIOID DRUGS
Naloxone will not reverse the effects of
benzodiazepines or alcohol however if
the issue is poly drug use and one of
the drugs is an opioid, giving naloxone
may be enough to temporarily reverse
the symptoms of overdose.
13. When naloxone is administered to
someone they will always experience
withdrawals
FALSE
Severity of symptoms of withdrawal are linked
to dose of naloxone administered. By giving
one dose of naloxone at a time the risk of
severe withdrawal may be less.
14. How many does of naloxone are in the prefilled syringe used in Scotland?
e. 5
There are 5 x 0.4mL doses in each pre-filled
syringe. This equates to 0.4mg naloxone per
dose
15. Into which area of the body should clients
be advised to administer naloxone
a. THIGH
Clients should be advised to administer the
injection into the muscle of the outer thigh. It is
not necessary to remove clothing but do check
for any obstructions such as coins, a phone or
a wallet. There are 2 needles contained in
each kit. The second is provided should the
first needle become damaged or bent. It is not
necessary to change it between every dose
administered.
16. How long before the effects of naloxone
start to wear off?
b. 20-30 minutes
The effects of naloxone are short lived and begin
to wear off after 20-30 minutes. Opioids will begin
to reattach to receptors. This poses a danger to
people who have been given naloxone and go on
to use further drugs to combat any symptoms of
withdrawal. Clients should be made aware of the
dangers of topping up with additional drugs.
17. Who can administer naloxone?
e. Anybody
Legislation is in place which allows
anybody to administer naloxone for the
purposes of saving a life.
18. You should never administer naloxone to
a pregnant woman
FALSE
Administering naloxone may cause
distress to the unborn baby due to
potential for withdrawal however not
giving naloxone may cause both the
mother or baby to die.
19. What is the ratio of chest compressions to
breaths for Cardio Pulmonary
Resuscitation?
d. 30:2
The ratio is 30 chest compressions followed by 2
breaths. Breaths are still encouraged due to the
depleted oxygen stores in the blood as this is a
respiratory event.
Naloxone should be administered after the first
cycle then every 3 cycles thereafter until all
doses are used or the ambulance has arrived
and paramedics have taken over.