School of Pharmacy and Pharmaceutical Sciences, Binghamton University, Binghamton, NY, USA.
Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
Addiction. 2018 Dec;113(12):2300-2304. doi: 10.1111/add.14416. Epub 2018 Sep 11.
Expanded access to naloxone has been identified as a key intervention for reducing opioid-related morbidity and mortality. It is not known which naloxone device will result in rapid, successful administration when administered by community members. The aims of this study were to estimate and compare (1) the rate of successful administration and (2) time to successful administration for single-step nasal spray, multi-step atomized nasal spray and intramuscular simulated naloxone by community members.
A prospective, single-site, open-label, randomized usability assessment of simulated naloxone administration in a convenience sample of community members. Participants were randomized to single-step nasal spray (SP), multi-step atomized nasal spray (AT) or intramuscular simulated (IM) naloxone and asked to administer the simulated medication to a mannequin after completing a 2-minute training video.
New York, USA at a state fair that attracts between 60 000 and 120 000 individuals daily.
A total of 138 participants completed the study over a 2-day period in September 2016. All participants were at least 18 years of age and had no prior naloxone training.
The rate of successful administration and time to successful administration were recorded for each device.
The SP device (100%; P < 0.001) had a higher rate of success compared with the IM device (69.6%). Although success differed between the AT (89.1%) device and IM device, as well as the AT device and SP device, these differences were not significant. The SP device also had a shorter median time to successful administration (34.3 sec) compared with the IM (99.9 sec; P < 0.001) and AT (110.3; P < 0.001) devices.
After video training, community members are able to (1) administer single-step nasal spray naloxone with a higher rate of success than intramuscular naloxone in a simulated overdose setting and (2) administer single-step nasal spray naloxone more rapidly than both intramuscular and multi-step atomized nasal spray naloxone.
扩大纳洛酮的使用途径已被确定为降低阿片类药物相关发病率和死亡率的关键干预措施。目前尚不清楚当社区成员使用时，哪种纳洛酮设备将导致快速、成功的给药。本研究的目的是评估和比较（1）成功给药率和（2）社区成员模拟使用纳洛酮时，单步鼻喷、多步雾化鼻喷和肌内注射的成功给药时间。
在一个方便的社区成员样本中，对模拟纳洛酮给药进行前瞻性、单站点、开放标签、随机可用性评估。参与者被随机分为单步鼻喷（SP）、多步雾化鼻喷（AT）或肌内模拟（IM）纳洛酮，并在完成 2 分钟的培训视频后，要求他们向模拟人身上给药。
美国纽约州，在一个吸引每天 60000 至 120000 人的州博览会上。
共有 138 名参与者在 2016 年 9 月的两天内完成了这项研究。所有参与者年龄至少 18 岁，且没有接受过纳洛酮培训。
记录每个设备的成功给药率和成功给药时间。
SP 设备（100%；P<0.001）的成功率高于 IM 设备（69.6%）。尽管 AT 设备（89.1%）与 IM 设备以及 AT 设备与 SP 设备之间的成功率存在差异，但这些差异并不显著。SP 设备的中位成功给药时间也更短（34.3 秒），与 IM （99.9 秒；P<0.001）和 AT （110.3 秒；P<0.001）设备相比。
在视频培训后，社区成员能够（1）在模拟过量用药环境下，以高于肌内纳洛酮的成功率给予单步鼻喷纳洛酮，（2）比肌内和多步雾化鼻喷纳洛酮更快地给予单步鼻喷纳洛酮。
