How to treat an opioid overdose with naloxone
Other platforms explain it with text and video. In VMS you practice it on the patient.
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
Scene safety
Gloves on and watch for needles and powders. [1]
Check response and breathing
Tiny pupils, slow or no breathing and no response suggest an opioid overdose. [1]
Ventilate
If breathing is slow or absent, open the airway and ventilate with a bag-valve mask and oxygen. [1]
Give naloxone
Nasal spray (often 4 mg in one nostril) or IM or IV in smaller doses titrated to breathing, per protocol. [1]
Reassess and repeat
If breathing does not improve in 2 to 3 minutes, give another dose. Keep ventilating meanwhile. [1]
After it works
Recovery position, keep monitoring. Naloxone can wear off before the opioid, so breathing can stop again. [1]
Expect withdrawal
The patient may wake up agitated, vomiting or in pain. Stay calm and explain what happened. [1]
Common errors
- Giving naloxone and not ventilating.
- Giving a large dose to fully wake the patient.
- Leaving the patient alone after they wake up.
Practice it in VMS
In VMS 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.
VMS cases that train this skill
Sources
Facts and steps follow NASEMSO National Model EMS Clinical Guidelines. VMS is not affiliated with these organizations. Updated: 2026-10-11.