NARCAN Training Video Follow-up Survey Questionnaire

1.Chose the correct order of steps to follow when responding to an overdose:

Check for responsiveness, call 911, give NARCAN, provide rescue breathing or place person in recovery position, and stay with person until help arrives.

Check for responsiveness, give NARCAN, call 911, stay with the person until help arrives, and provide rescue breathing or place person in recovery position.

Call 911, give NARCAN, check for responsiveness, provide rescue breathing or place person in recovery position, and stay with person until help arrives.

2.True or False: A person who helps someone experiencing an overdose is immune from criminal prosecution for possession of controlled substances or drug paraphernalia.

True

False

3.Signs and symptoms of an opioid overdose includes all of the following EXCEPT (Choose ONE response for your answer):

Unresponsive and Unconscious

Breathing is slow, shallow, or the person is not breathing

Fever

Pulse slow or irregular

Loud snoring or gurgling noises wiht breathing

Body is limp

Skin is pale/gray, clammy, or cool

Lips, fingers and/or toes may be blue in color

4.Name of Participant:

5.Email of Participant:

6.Business Name/Government Name/School Name where Overdose Kit will be located.

7.How would you like to receive your Overdose Tool Kit?

Pick-up at NEWAHEC Office located at 621 York Street. Monday-Thursday from 8am to 3pm.

Delivered to Location (Address in Question 6)

8.Delivery Location if you picked this option in Question 6.

Current Progress,

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