Intranasal Naloxone Protocol


For use on patients suspected of opiate overdose.


  1. Assess ABC’s – Airway, Breathing, Circulation
  2. For pulseless patients, proceed to ACLS guidelines
  3. Apnoea with pulse – Establish oral airway and begin bag ventilation with 100% Oxygen.
  4. Load syringe with 2 mg (2 ml) of Naloxone and attach nasal atomizer.
  5. Place atomizer within the nostril.
  6. Briskly compress syringe to administer 1 ml of atomised spray.
  7. Remove and repeat in other nostril, so all 2 ml (2 mg) of medication are administered.
  8. Continue ventilating patient as needed.
  9. If no arousal occurs after 5-10 minutes, proceed down standard unconscious protocol including injectable Naloxone and secure airway if necessary.

Content by Dr Jason Van der Velde Dr Íomhar O' Sullivan 31/07/10. Last review Dr ÍOS 3/12/18