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  • Naloxone Usage Form

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Print Form New York State Public Safety Naloxone Quality Improvement Usage Report Version: 05/23/2014 Arrival Time of Officer: Date of Overdose: : Zip Code Where Overdose Occurred: : PM AM Gender.

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For nasal dosage form (® spray): Adults and children—At first, 2 or 4 milligrams (mg) (1 spray into one nostril). Another spray may be given into the other nostril every 2 to 3 minutes until the patient responds or until emergency medical assistance becomes available.

There are two forms of naloxone that anyone can use without medical training or authorization: prefilled nasal spray and injectable. Prefilled devices that spray medication into the nose. Medication (solution) given by injection into a muscle or under the skin.

Naloxone is able to be administered through several different methods. This includes an autoinjector, a syringe, a nasal spray, and an atomizer.

Naloxone (the generic name) is also sold under the brand names ® and ®. There are three types of naloxone available: injectable; auto- injectable; and prepackaged nasal spray.

Naloxone can be given as a nasal spray or it can be injected into the muscle, under the skin, or into the veins. Steps for responding to an opioid overdose can be found in the Substance Abuse and Mental Health Administration's (SAMHSA) Opioid Overdose Prevention Toolkit.

The medication can be given by intranasal spray (into the nose), intramuscular (into the muscle), subcutaneous (under the skin), or intravenous injection.

There are three types of naloxone available: injectable; auto- injectable; and prepackaged nasal spray. In Georgia, you can purchase naloxone from your pharmacist without a prescription from your doctor. Not all pharmacies carry naloxone, so call ahead to determine if your pharmacy stocks naloxone.

Gently insert the tip of the nozzle into one nostril, until your fingers on either side of the nozzle are against the bottom of the person's nose. Press the plunger firmly to give the dose of ® Nasal Spray. Remove the ® Nasal Spray from the nostril after giving the dose.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232