First Due Academy MedicalEMREMTAEMTParamedic

Opioid Overdose — Utah 2025 Protocol

Airway first. Titrate naloxone to BREATHING, not consciousness. Always transport.

Steps by Cert Level

ALL: Airway FIRST — BVM if apneic. O2. Positioning. Recognize opioid toxidrome: miosis + respiratory depression + decreased LOC.
EMT: Naloxone 2mg IN (one spray per nostril).
AEMT: Naloxone 0.4mg IV/IO/IM — titrate to adequate respirations, NOT full reversal.
PARAMEDIC: Naloxone 0.4mg IV/IO/IM, repeat q2–3min as needed. Titrate to breathing. Consider higher/repeated doses for fentanyl/carfentanil.