Internship AbstractTitle: New Jersey Basic Life Support Emergency Medical Services Naloxone Analysis

Name: Evan Gross

Preceptors: Dr. Terry Clancy, Chief of Education, Certification, and Technology

Agency: New Jersey Department of Health Office of Emergency Medical Services (OEMS)

Purpose: To analyze the Naloxone (Narcan®) Basic Life Support (BLS) program data for New Jersey and make policy recommendations to improve pre-hospital response to opioid overdoses.

Significance: From 1999 to 2013, the drug poisoning death rate from opioids has more than tripled. Heroin, a type of opioid, has caused many deaths since 2010; and from 2012 to 2013, had increased by 39% in the United States (U.S. Department of Health and Human 2015). This epidemic has affected NJ as well, leading to policy changes. The Overdose Prevention Act authorized Emergency Medical Technicians (EMTs) to administer Naloxone (NJ Public Law 2013). Naloxone administration data in New Jersey has been collected but not analyzed thus far. The data analyzed may identify gaps to improve future data collection methods, BLS education, and treatment strategies.

Method/Approach: A retrospective review of NJ Naloxone Medication Administration Reports (MARs) from BLS agencies from April 2014 through December 2015 was performed. Naloxone MARs were reported by EMT’s into the Hippocrates database. 1,373 MARs were exported from Hippocrates to Excel and analyzed. 152 entries were removed due to the following criteria: practice MARs, unregistered police and fire agencies, and Naloxone administrations that deviated from the 2mg protocol. The metrics analyzed for the 1,221 remaining data entries included the top three NJ counties with the highest amount of administrations. In addition, statewide totals of age, gender, and patient responses to BLS Naloxone administration were included in the analysis.

Outcomes: Quantitative data analysis indicated that the three counties with the highest number of EMT Naloxone administrations were Camden County (n=398), Ocean County (n=129), and Hudson County (n=128). Statewide, the age ranges with the highest number of Naloxone administrations were 453 (37.1%) in the 20-29 years of age (YOA) group, 330 (27.0%) in the 30-39 YOA group, and 205 (16.8%) in the 40-49 YOA group. Statewide, there were approximately 2.7 times more male patient Naloxone administrations (n=887; 73%), than female patient Naloxone administrations (n=334; 27%). Lastly, it was found that 878 (72%) patients had a response to Naloxone administration (i.e. alert, oriented, confused, vomiting, and/or combative), 241 (20%) patients had no response to Naloxone administration, and 102 (8%) had an unknown or other response to Naloxone administration.

Evaluation: This project evaluated select variables of the NJ EMT Naloxone program. These variables can be further analyzed to identify issues with Naloxone administration, MAR reporting, and treatment strategies. This preliminary data analysis provide OEMS and their stakeholders with targeted populations and areas to enhance treatment and prevention initiatives, with the goal of improving the public health response to the opioid epidemic.

Internship AbstractCitation(s)