Chest compressions and rescue breathing when administering naloxone in opioid overdose

Key take-home messages

• Opioid overdoses cause respiratory failure (a reduction or stop in breathing), which can lead to cardiac arrest.
• In the event of a suspected opioid overdose, bystanders should call 911 and administer naloxone before any attempts at resuscitation.
• Various expert groups have differing opinions on the appropriateness of using chest compressions only, rescue breathing only or chest compressions combined with rescue breathing when trying to resuscitate someone experiencing an opioid overdose.
• In general, chest compressions are recommended for someone experiencing a sudden cardiac arrest while rescue breathing is critical for people experiencing respiratory failure. However, it can be difficult for bystanders to distinguish between the signs of respiratory failure and cardiac arrest and know how to respond.
• Three factors should be taken into consideration when determining how best to respond: bystander skill-level (i.e. ability to recognize signs of opioid overdose and perform CPR), certainty of cardiac (heart) or pulmonary (lung) function and type and amount of opioids involved.
• There is not enough data to strongly recommend prioritizing chest compressions and/or rescue breathing.

• Population(s)
  • People who use drugs
• Prevention
  • Drug use behaviours/harm reduction
• Health Systems
  • Delivery arrangements