Before we begin it’s important to remember that before administering the medication you must check the name, dose, and expiry date on the ampule to ensure that you’re giving the right medication and dose through the correct route and in this case it’s intramuscular. To do a single 0.4 milligram naloxone injection, you will need; an ampule of naloxone, a 25 gauge one inch needle with a 1 millilitre or three millilitre barrel. Preferably, all attached as a single unit and safety engineered for our auto retracting. You will also need an unopened alcohol pad, or a new two-by-two gauze, or an amp snapping cap. To practice and injection you can inject water into an orange or a muscle simulation pad. For us this means that before administering naloxone to someone experiencing opioid overdose we need to check that the ampule is labeled naloxone for injection. Check the dose 0.4 milligrams per millilitre and volume of the ampule one millilitre. This ampule holds our full single-dose. The expiry date here says 10 2016 and because it is December 2015 now we are okay to use this naloxone. To open the naloxone ampule, start by making sure that all of the liquid naloxone is in the body of the ampule. If any of the naloxone is stuck in the conical tip of the amp like this, it can be displaced by gently flicking the stem of the ampule or by wind mailing the ampule like so. Next, locate the small landmarking . above the neck of the amp. This will serve as a reference for where to place the thumb of your dominant hand when breaking open the amp. Holding the amp in your other hand, take an unopened alcohol swab or two by two gauze pad between the index finger and thumb of your dominant hand. Place it over the tip of the ampule above the neck of the amp. Your thumb should cover the landmark dot and thumbnail should be aimed towards you. Next, apply outward pressure with your thumb against the ampule top, this will apply enough pressure along the pre-scored neck of the ampule to cleanly break it open. Alcohol swabs or gauze pads are not necessary if you’re ampule tip has a protective cap. You just need to follow the same procedure. Discard the ampule top directly into the sharps container or aside in a safe place for later disposal. Now place the ampule onto a steady surface while you uncap the needle and syringe. Holding the barrel with your dominant hand submerge the tip of the needle into the liquid naloxone. Next, steadily draw back the plunger to fill the syringe with your naloxone dose. Ensure that the tip of the needle stays in the liquid until the desired dose is drawn up. This along with a quick and steady drawing speed will help to minimize air bubbles. If you are using a 1 millilitre syringe then you will be filling the entire barrel to the one milliliter mark and if you are using a 3 millilitre syringe, your dose will only fill one third of the barrel to the one milliliter mark. You are now ready to administer naloxone. Naloxone should be administered intramuscularly meaning in the muscle or IM for short. The best injection sites are the deltoid muscle in the upper arm or the vastus lateralis muscle – the outer side of the thigh. Ideally, the skin over the muscle site should be exposed, however, the needle will go through light clothing, although it is best practice to clean the site with an alcohol pad before any injection, this should not delay naloxone administration. Here i am using a muscle simulator to demonstrate the naloxone injection. To administer a naloxone dose, hold the dosed syringe like a dart in your dominant hand. Use your other hand to hold the skin tight around the injection site. Holding the syringe barrel at a 90-degree angle above the site, quickly push the needle through the skin, then use your thumb or other hand to push the plunger all the way down to the bottom of the barrel. If you are using a safety-engineered retractable needle like this one, you will hear a click after the plunger is fully deployed and the needle will disappear into the barrel. This will keep you safe from needle stick injury after the naloxone is administered. If you are using a non-safety engineered needle, it is important to discard it into a biohazard container immediately after administering than the naloxone. Safety engineered syringes should also be discarded into a biohazard bin as soon as possible. We’ve now completed all of the steps for administering a dose of naloxone. If you have any questions or if you need more information about the administration of naloxone, please contact The Works or visit our website.