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Emergencies and resuscitation

How to treat an opioid overdose with naloxone

Other platforms explain it with text and video. In Making Synapses you practice it on the patient.

EMS (NREMT)Nursing (NCLEX)
Practice it in VR with Blocky

In an opioid overdose the danger is stopped breathing. Ventilation comes first; naloxone is given to bring breathing back, not to fully wake the patient.

Step by step

  1. Scene safety

    Gloves on and watch for needles and powders. [1]

  2. Check response and breathing

    Tiny pupils, slow or no breathing and no response suggest an opioid overdose. [1]

  3. Ventilate

    If breathing is slow or absent, open the airway and ventilate with a bag-valve mask and oxygen. [1]

  4. Give naloxone

    Nasal spray (often 4 mg in one nostril) or IM or IV in smaller doses titrated to breathing, per protocol. [1]

  5. Reassess and repeat

    If breathing does not improve in 2 to 3 minutes, give another dose. Keep ventilating meanwhile. [1]

  6. After it works

    Recovery position, keep monitoring. Naloxone can wear off before the opioid, so breathing can stop again. [1]

  7. Expect withdrawal

    The patient may wake up agitated, vomiting or in pain. Stay calm and explain what happened. [1]

Common errors

Practice it in Making Synapses

In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

Making Synapses cases that train this skill

17 Making Synapses cases train this skill: open the case library

Sources

  1. NASEMSO National Model EMS Clinical Guidelines

Facts and steps follow NASEMSO National Model EMS Clinical Guidelines. Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.