Naloxone (Narcan) administration

The purpose of this report is to collect data about the training, implementation, and effectiveness of this addition to the BLS protocols, for continuous quality improvement.

The use of Naloxone (Narcan) by BLS providers in Whatcom County to treat life-threatening opioid overdose is optional. However, responders with agencies that choose to carry and use Naloxone are required by the State of Washington to complete the 4 hour training program approved by the MPD and Education Committee.

For information and FAQs about public use of Naloxone in Washington, please visit

* 1. Incident Date:

* 2. Agency Incident Number:

* 3. District/Agency AND Station #:

* 4. Name of Provider completing this report

* 5. Indications for Naloxone use (choose all that apply)

* 6. Naloxone was first administered by

* 7. In what way(s) did the patient respond to Naloxone administration (choose all that apply)

* 8. How was the patient transported to the ED?

* 9. Narrative: (Complete this section in order to document the circumstances of the intervention, note any problems, and/or to include other information relevant to data collection for educational, statistical, and quality assurance purposes)