YEAH.
HI, IS ONE OF YOU MS. HALL?
UH, YEAH. THAT'S ME, BUT PLEASE CALL ME MARTY,
AND THIS IS MY ROOMMATE JEN.
HEY.
I TOLD CHARLENE I THOUGHT IT WOULD BE GOOD
IF SHE SAT IN.
AND I'M HER RIDE ANYWAY, SO I MIGHT AS WELL LEARN
SOMETHING, RIGHT?
YEAH. WELL, IT'S NICE TO MEET YOU BOTH.
MY NAME IS JACK CARTWRIGHT, I'M A CLINICAL
PHARMACIST, AND I'D LIKE TO SHOW YOU HOW TO USE
THE NALOXONE NASAL SPRAY IN CASE OF
AN OPIOID OVERDOSE.
- IS THAT OK? - YEAH.
- SURE. - GREAT.
WE'RE GOING TO DO A BIT OF HANDS-ON TRAINING
IN A MOMENT, BUT I WANTED TO MAKE SURE YOU KNEW THAT
THIS WASN'T YOUR ONLY CHANCE TO
LEARN EVERYTHING.
WE ALSO HAVE WRITTEN MATERIALS YOU'LL BE ABLE
TO TAKE AWAY WITH YOU, AND WE'RE GOING TO HAVE VIDEOS
ONLINE YOU'LL BE ABLE TO WATCH AT ANY TIME.
SO IF YOU'RE CONCERNED YOU WON'T BE ABLE TO REMEMBER
EVERYTHING AFTER YOU LEAVE HERE TODAY, IT'S OK.
THERE ARE LOTS OF WAYS TO REVIEW THE
INSTRUCTIONS AND INFORMATION LATER.
DOES THAT SOUND GOOD?
- YEAH. - SURE.
GREAT. OK.
SO HERE IS YOUR NALOXONE NASAL SPRAY, AND, UH,
WE'LL GO OVER IT TOGETHER.
OK. SO RULE NUMBER ONE-- BRING YOUR NALOXONE
NASAL SPRAY WITH YOU WHEREVER YOU GO.
IF YOU'RE DRIVING, HAVE IT IN YOUR CAR.
IF GO INSIDE YOUR HOME, TAKE IT INSIDE WITH YOU.
IF YOU GO ON VACATION, THEY GO WITH YOU.
SO LIKE A DIABETIC WOULD KEEP HER INSULIN WITH HER.
RIGHT.
OR AN EPI PEN IF YOU WERE ALLERGIC TO BEE STINGS.
EXACTLY!
RULE NUMBER TWO IS DON'T STORE THE NASAL SPRAY
FOR PROLONGED PERIODS OF TIME
IN EXTREME TEMPERATURES.
YOU SHOULD AVOID HEAT, COLD, OR DIRECT SUNLIGHT
TO TRY TO KEEP IT AT ROOM TEMPERATURE.
OTHERWISE, THE DRUG MAY NOT WORK AS WELL.
NOW DO YOU REMEMBER WHAT RULE NUMBER ONE WAS?
BRING IT WITH ME!
EXACTLY!
YOU NEVER KNOW WHEN YOU MIGHT NEED IT.
NOW YOU ALREADY WENT OVER THE SIGNS OF OPIOID
OVERDOSE WITH CHARLENE, RIGHT?
YES.
UH, CHECK, LISTEN, LOOK, AND...TOUCH!
SO CHECK FOR DEEP SLEEP.
SHAKING WON'T WAKE YOU.
LISTEN FOR SNORING THAT SOUNDS LIKE CHOKING, UH,
BREATHING STOPPED, OR REALLY SLOW, LIKE ONCE
EVERY 5 SECONDS.
LOOK FOR BLUE OR GRAY LIPS OR FINGERNAILS...
AND TOUCH FOR PALE OR CLAMMY SKIN.
BINGO!
SO NOW YOU KNOW WHEN YOU MIGHT NEED TO USE
THE NALOXONE.
NOW LET'S MAKE SURE YOU KNOW HOW TO USE IT.
SO WHEN I TALKED TO CHARLENE, I THOUGHT IT WAS
JUST LIKE NASAL SPRAY YOU GET FOR ALLERGIES OR
WHATEVER, BUT SHE SAID NOT EXACTLY.
YEAH, IT'S A LITTLE MORE TO IT THAN THAT.
ALTHOUGH THE POSITIONING OF THE FINGERS, WHICH
WE'LL GO OVER IN A MINUTE, IS SIMILAR.
THERE'S ONE VERY IMPORTANT DIFFERENCE.
YOU SHOULD NOT PRIME OR TEST THE SPRAY BECAUSE IT
ONLY HAS ONE DOSE IN IT.
THIS IS REALLY IMPORTANT.
- OK. - OK, YEAH.
WHAT'S NICE IS THERE ARE LOTS OF PLACES TO GET
INFORMATION ABOUT USING THE NASAL SPRAY.
IN FACT, THERE ARE 4 PLACES.
IN CASE THE THIRD TIME'S NOT THE CHARM.
STOP.
WELL, WE KNOW OVERDOSE EMERGENCIES CAN BE REALLY
SCARY, AND WE WANT YOU TO KNOW WHAT TO DO EVEN IF
YOU'RE FRIGHTENED AND OVERWHELMED.
THAT'S WHY WE DO THESE SESSIONS AND WHY IT'S
HELPFUL TO HAVE THE INFORMATION
IN MULTIPLE PLACES.
SO THE 4 PLACES TO GET THE NASAL SPRAY
INSTRUCTIONS ARE: ONE, RIGHT HERE ON THE BOX ITSELF;
TWO, INSIDE THE BOX...
RIGHT HERE--THIS ALSO HAS Q&As, SIDE EFFECTS,
AND OTHER PHARMACEUTICAL INFORMATION;
3, ON THE QUICK START GUIDE, WHICH IS LOCATED INSIDE
OF THE NASAL SPRAY; AND JUST IN CASE THAT'S NOT
ENOUGH INFORMATION, THE VA's PUT TOGETHER THIS
REALLY EASY-TO-READ OPIOID OVERDOSE BROCHURE.
JEN: THANKS.
MARTY: SO, YEAH, LIKE YOU SAID, A LOT OF PLACES TO
GET INFORMATION.
- RIGHT. - MM-HMM.
NOW THE VA's BROCHURE ISN'T MEANT TO REPLACE
THE INSTRUCTIONS THAT COME IN THE BOX, SO YOU SHOULD
DEFINITELY READ THOSE, TOO.
SO NOW THAT YOU KNOW WHERE THE INSTRUCTIONS ARE,
LET'S TALK ABOUT THE ACTUAL NASAL SPRAYS.
IN EACH BOX, THERE ARE TWO NASAL SPRAYS.
NOW THE SPRAYS COME SEALED IN PLASTIC TO KEEP THEM
CLEAN, AND SINCE THESE ARE YOUR NASAL SPRAYS, WE'RE
GOING TO KEEP THEM SEALED, BUT I'LL WALK YOU THROUGH
THE NEXT STEPS.
TO OPEN THE PACKAGE, TURN IT OVER AND FIND THE TAB
MARKED WITH A CIRCLE.
YOU PEEL IT BACK AND REMOVE AND REVIEW
THE QUICK START GUIDE RIGHT THERE.
NOW I'VE BROUGHT A DEMONSTRATION DEVICE WE
CAN LOOK AT.
SO TO USE IT, HOLD THE SPRAY BY PUTTING YOUR
THUMB ON THE BOTTOM OF THE PLUNGER AND YOUR FIRST
AND MIDDLE FINGERS ON EITHER SIDE OF THE NOZZLE.
NOW REMEMBER, DO NOT PRIME OR TEST THE SPRAY
BECAUSE YOU COULD WASTE THE LIFE-SAVING
MEDICATION INSIDE.
IT'S SO TINY!
LOOK AT THAT.
WOW.
IT'S AMAZING HOW THIS COULD SAVE YOUR LIFE.
I PROMISE, IT WORKS!
NOW TO ADMINISTER THE MEDICINE, UM--I'LL SHOW
YOU IN HERE.
MM-HMM.
YOU TILT THE PERSON'S HEAD BACK LIKE THAT, AND YOU
WANT TO GIVE SUPPORT AT THE BACK OF THE NECK WITH YOUR HAND.
GENTLY INSERT THE TIP OF THE NOZZLE INTO
THE PERSON'S NOSTRIL UNTIL YOUR FINGERS ON EITHER
SIDE OF THE NOZZLE TOUCH THE BOTTOM
OF THE PERSON'S NOSE.
THEN PRESS THE PLUNGER WITH YOUR THUMB FIRMLY,
ALL THE WAY IN TO GIVE THE FULL DOSE OF NALOXONE.
AND HOW DO YOU KNOW THAT YOU'VE GIVEN
THE RIGHT DOSE?
ONCE THE PLUNGER WON'T PUSH IN ANYMORE, YOU'LL
KNOW YOU'VE GIVEN THE FULL AND CORRECT DOSE.
JEN: IS IT POSSIBLE TO GIVE TOO MUCH?
YOU DON'T REALLY HAVE TO WORRY ABOUT THAT.
THE SPRAY ONLY CONTAINS ONE DOSE, AND YOU CAN'T
REALLY OVERDOSE ON NALOXONE ANYWAY.
AND ONE DOSE DOES IT?
USUALLY, BUT IF THE PERSON'S STILL SHOWING
SIGNS OF OVERDOSE AFTER 2 OR 3 MINUTES OR STOPS
BREATHING, WHICH CAN HAPPEN, THEN YOU GIVE
A SECOND DOSE.
THAT'S WHY THERE'S A SECOND NALOXONE SPRAY
IN THE KIT JUST IN CASE YOU NEED IT.
YOU'D FOLLOW THE SAME STEPS AS YOU DID
WITH THE FIRST DOSE.
IT'S IMPORTANT TO CALL 911 RIGHT AFTER YOU'VE
GIVEN THE FIRST DOSE SO PARAMEDICS WILL BE
ON THEIR WAY.
WOW. I'M GLAD THAT WE HAVE THAT SECOND DOSE.
MM-HMM.
AND I CAN SEE WHY YOU'D WANT TO CALL 911.
YEAH. YOU DEFINITELY DON'T WANT TO DO THIS ALL
ON YOUR OWN.
MM-HMM.
OK. THE LAST THING I WANT TO POINT OUT IS WHAT TO DO
AFTER YOU'VE USED THE NASAL SPRAY.
ONCE IT'S BEEN USED, MAKE SURE YOU DISPOSE
OF THE SPRAY IN A SAFE WAY.
MAKE SURE YOU THROW IT AWAY OUT OF REACH OF CHILDREN
AS IT SAYS THERE.
- GOT IT. - OK.
GREAT.
ALSO, IF YOU USE YOUR NASAL SPRAYS OR IF THEY
EXPIRE, IT'S REALLY IMPORTANT TO LET YOUR
PROVIDER KNOW AND ASK FOR ANOTHER ONE.
IF YOU USE THE NASAL SPRAYS, WE'LL WANT TO
CHECK IN TO FIND OUT WHAT HAPPENED, HOW YOU'RE
DOING, AND SEE IF THERE'S ANYTHING ELSE WE CAN
DO TO HELP.
WE'LL BE SURE TO SEND YOU A NEW PRESCRIPTION RIGHT
AWAY BECAUSE YOU SHOULD NEVER BE WITHOUT ONE.
ANY QUESTIONS?
NO.
UH, THAT MAKES SENSE.
JUST HOPING I DON'T HAVE TO CROSS THAT BRIDGE.
THAT'S FOR SURE.
YEAH, AND WE HOPE SO, TOO, AND THAT'S WHY
THE EDUCATION CHARLENE GAVE YOU ON HOW TO PREVENT
AN OPIOID OVERDOSE IS SO IMPORTANT.
HOPEFULLY YOU WON'T NEED TO USE THE NASAL SPRAYS,
BUT IF AN EMERGENCY DID HAPPEN, YOU'RE NOW BOTH
FULLY TRAINED EMERGENCY NALOXONE ADMINISTRATORS.
THANKS.
THANK YOU.
GREAT. WELL, IF WE DON'T HAVE ANY MORE QUESTIONS, I
CAN GET THIS STUFF PACKAGED UP,
AND YOU CAN TAKE THAT HOME.
I'LL TAKE THIS BACK. GREAT.