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E.P.P. 060 LONGWOOD POLICE DEPARTMENT ENFORCEMENT POLICY & PROCEDURE NUMBER: EPP - 60 SUBJECT: OPIOID OVERDOSE EMERGENCY RESPONSE EFFECTIVE: MARCH 1, 2019 REVISED: JANUARY 1, 2024 ENFORCEMENT POLICY & PROCEDURE OPIOID OVERDOSE EMERGENCY RESPONSE EPP – 60 PAGE 1 OF 6 I. PURPOSE: Longwood Police Department officers may encounter a person who is experiencing an opioid- involved overdose. The Longwood Police Department has emergency response guidelines for officers to provide first responder emergency care to those individuals. The objective is to reduce fatalities associated with opioid-involved overdoses. II. SCOPE This policy establishes guidelines and responsibilities for members when encountering someone who is experiencing an opioid-involved overdose. These guidelines are approved by the Seminole County Medical Director and permitted by Florida statute 381.887. III. DEFINITIONS A. Opioid: An opioid is a medication or drug that is derived from the opium poppy or that mimics the effect of an opiate. Opiate drugs are narcotic sedatives that depress activity of the central nervous system; which will reduce pain, induce sleep, and in overdoses, will cause people to stop breathing. First responders often encounter opiates in the form of morphine, methadone, codeine, heroin, fentanyl, oxycodone (OxyContin® and Percocet®), and hydrocodone (Vicodin®). B. Emergency Opioid Antagonist: A prescribed medication, to include Naloxone hydrochloride or any similarly acting drug, which 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 system and respiratory system. It is marketed under various trademarks, including Naloxone/Narcan®. It provides only temporary reversal, therefore it is not a substitute for emergency medical care. ENFORCEMENT POLICY & PROCEDURE OPIOID OVERDOSE EMERGENCY RESPONSE EPP – 60 PAGE 2 OF 6 C. Naloxone/Narcan® Nasal Spray: A medically approved emergency opioid antagonist delivery system, approved by the Seminole County Medical Director, which delivers Naloxone hydrochloride or a similarly acting drug by means of nasal passage delivery (IN). D. Patient: A person encountered by a first responder who is at risk of experiencing an opioid overdose. E. Emergency Opioid Antagonist Program Coordinator: A Longwood Police Department member designated by the chief as the program coordinator. IV. TRAINING A. All members will receive training, as approved by the chief, on the use of Naloxone/Narcan® nasal spray which will include an overview of Florida statute 381.887 (permits law enforcement use), proper utilization, storage and patient assessment. B. All members will receive periodic Naloxone/Narcan® nasal spray refresher training, as approved by the chief. V. ISSUANCE, STORAGE AND REPLACEMENT OF NALOXONE/NARCAN NASAL SPRAYS: A. First responder members who have completed the training will be issued Naloxone/Narcan® nasal spray with issuance to other trained members as deemed necessary by the program coordinator. B. Members will carry the Naloxone/Narcan® nasal spray in a uniform shirt pocket or other readily accessible location on their person. C. Naloxone/Narcan® nasal spray must be stored at room temperature (59°F to 77°F) with short term exposures up to 104°F permitted. Naloxone/Narcan® nasal spray should not be frozen, stored in a vehicle or in direct sun light. D. Members will securely store issued Naloxone/Narcan® nasal spray when not being carried to prevent access by citizens and untrained members. E. Supervisors will inspect Naloxone/Narcan® nasal sprays during regular inspections and document the results on the agency inspection form. During inspections supervisors will ensure the Naloxone/Narcan® nasal sprays are not damaged or expired. ENFORCEMENT POLICY & PROCEDURE OPIOID OVERDOSE EMERGENCY RESPONSE EPP – 60 PAGE 3 OF 6 F. Members with lost or damaged Naloxone/Narcan® nasal sprays will submit a memorandum of explanation to the chief through the chain of command. G. Members with used, lost, damaged, or expired Naloxone/Narcan® nasal spray will submit an equipment request for replacement on the same work day the need was discovered. H. Expired Naloxone/Narcan® nasal sprays will be returned to the program coordinator. VI. PROCEDURES A. Members who have completed the training and have been issued Naloxone/Narcan® nasal spray will adhere to the following procedures when encountering a person who may be experiencing an opioid- involved overdose. 1. If a member encounters a person who may be experiencing an overdose, the member will immediately request a response from fire rescue. 2. Members will determine the need for treatment with Naloxone/Narcan® nasal spray by evaluating all information known at that time to include patient responsiveness, pulse and breathing status. 3. Members will utilize personal protection equipment (P.P.E.) when administering Naloxone/Narcan® nasal sprays. 4. If the patient is unresponsive with no respirations or pulse, rescue C.P.R. will be administered as the primary means of first responder care. If the breathing of the patient becomes adequate and the patient has regained a pulse, the patient should be placed in the recovery position while breathing and pulse is monitored for deteriorating status until fire rescue personnel arrive. 5. If the patient is unresponsive with decreased or no respirations, the member will administer Naloxone/Narcan® nasal spray following the established training guidelines. Administering Naloxone/Narcan® nasal spray should only be administered if it does not cause an undue delay in providing rescue C.P.R. 6. If the member determines that for officer safety reasons or if deployment of the Narcan® nasal spray would cause an undue delay for providing rescue C.P.R. then the first responding member will proceed with rescue C.P.R. first and wait for the arrival of assistance before administering Naloxone/Narcan® nasal spray. 7. Officers will ensure that weapons or other items which can be used as weapons are not within reach of the patient when administering Naloxone/Narcan® nasal spray since patients who are revived from an opioid overdose may regain consciousness in an agitated or combative state. ENFORCEMENT POLICY & PROCEDURE OPIOID OVERDOSE EMERGENCY RESPONSE EPP – 60 PAGE 4 OF 6 8. If the patient responds to the administration of Naloxone/Narcan® nasal spray, and there is no evidence of trauma, the patient will be placed in the recovery position until fire rescue personnel assume treatment of the patient. Additional doses of Naloxone/Narcan® nasal spray may be administered after 3-5 minutes if the patient does not respond to the previous administration of Naloxone/Narcan® nasal spray. 9. If the administration of Naloxone/Narcan® nasal spray is not effective and the patient is still unresponsive without a pulse, members will continue administrating rescue C.P.R. and/or use an A.E.D., until fire rescue personnel assume treatment of the patient. 10. Members will inform fire rescue personnel that 4mg of Naloxone/Narcan® nasal spray has been administered and its effectiveness on the patient. 11. Since opioid-overdose patients may become agitated or combative, members will remain with the patient and follow during the hospital transport if requested by fire rescue personnel. 12. Members will notify their supervisor when they administer Naloxone/Narcan® nasal spray. 13. Members will document opioid-involved overdoses and the administration of Naloxone/Narcan® nasal spray in the appropriate Cafe Report, which will include a description of the nature of the incident, the extent of care the patient received and the patient’s status after receiving care. 14. Used Naloxone/Narcan® nasal sprays will be turned over at the scene to fire rescue personnel for proper disposal in their medical waste bag on each rescue or engine. If used Naloxone/Narcan® nasal sprays are not collected by fire rescue personnel members will dispose of Naloxone/Narcan® nasal sprays following the biohazardous waste and contamination management process provided in General Order 22- Safety in the Workplace. B. Members who do not have issued Naloxone/Narcan® nasal spray will adhere to the following procedures when encountering a person who may be experiencing an opioid- involved overdose. 1. The member will immediately request a response from fire rescue and an available member with issued Naloxone/Narcan® nasal spray. 2. If the patient is unresponsive with no respirations or pulse, rescue C.P.R. will be administered as the primary means of first responder care until assistance arrives. If the breathing of the patient becomes adequate and the patient has regained a ENFORCEMENT POLICY & PROCEDURE OPIOID OVERDOSE EMERGENCY RESPONSE EPP – 60 PAGE 5 OF 6 pulse, the patient should be placed in the recovery position while breathing and pulse is monitored for deteriorating status until fire rescue personnel arrive. 3. Since opioid-overdose patients may become agitated or combative a member will remain with the patient and follow during the hospital transport if requested by fire rescue personnel. 4. Members will document opioid related overdoses and the administration of Naloxone/Narcan® nasal spray in the appropriate Cafe Report, which will include a description of the nature of the incident, the extent of care the patient received and the patient’s status after receiving care. VII. RESTRICTIONS A. Naloxone/Narcan® nasal spray will not be issued to or used by anyone not properly trained. B. Members will utilize Naloxone/Narcan® nasal spray only on patients suspected of experiencing an opioid- involved overdose. VIII. PROGRAM COORDINATOR: A. The Program Coordinator or designee shall be responsible for the following: 1. Ensure that the Memorandum of Understanding (MOU) with the Seminole County Medical Director is current. 2. Confirm all Naloxone/Narcan® nasal sprays are current and not expired. 3. Review all member Naloxone/Narcan® nasal spray deployment incidents to ensure appropriate administration and proper documentation in Café. 4. Ensure Naloxone/Narcan® nasal spray replacements are completed when necessary. 5. Ensure all members using Naloxone/Narcan® nasal sprays have received approved training. 6. Ensure that inspections of all Naloxone/Narcan® nasal sprays are being conducted during regular inspections. 7. Manage the agency supply of Naloxone/Narcan® nasal sprays. 8. Complete an annual report to the Seminole County Medical Director, through the chain of command, no later than January 31st of each year. This report will ENFORCEMENT POLICY & PROCEDURE OPIOID OVERDOSE EMERGENCY RESPONSE EPP – 60 PAGE 6 OF 6 describe usage, results, and program coordinator recommendations for continued program evaluation.