Evidence-Based Guideline for EMS Administration of Naloxone for Opioid Overdoses produced by NASEMSO, NAEMSP and ACEP Collaboration

April 18, 2019

(Falls Church, Va.) The National Association of State Emergency Medical Services (EMS) Officials (NASEMSO), in collaboration with the National Association of EMS Physicians (NAEMSP) and the American College of Emergency Physicians (ACEP), announces the publication of the first evidence-based guideline for EMS administration of naloxone for suspected opioid overdoses. In spite of the dramatic increase in the number of opioid overdose events to which EMS personnel respond, there remain unanswered questions about the optimal use of naloxone, including: best possible route of administration; dosage (including timing of repeat doses); titration of naloxone until patient resumes sufficient spontaneous respiration versus resumes full consciousness; and if transporting patients to the hospital after a return of consciousness affects outcome. A primary objective of this project was to answer these questions through a rigorous, science-based approach and deliver an evidence-based guideline and model EMS treatment protocol for the prehospital management of patients with suspected opioid overdose.  The evidence-based guideline has been published by Prehospital Emergency Medicine and is available at Evidence-Based Guidelines for EMS Administration of Naloxone.

The Principal Investigator is Kenneth Williams, MD, FACEP, FAEMS (Providence, RI); co-investigators are Jeffrey Goodloe, MD, NRP, FACEP, FAEMS, (Tulsa, OK) and John Lyng, MD, FACEP, FAEMS, NRP (Minneapolis, MN). They led a multi-disciplinary technical expert panel comprised of persons with expertise in emergency medicine, pain management, pharmacology/toxicology, addiction management, guideline development methodology, as well as a patient advocate, EMS clinicians and EMS administrators. In addition to the evidence-based guideline and protocol, the 16-month project produced a training module. Further information about the Technical Expert Panel and other resources produced by the project are available at

The project was funded through support from the National Highway Traffic Safety Administration (NHTSA), Office of EMS, and the Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau’s EMS for Children Program, as well as in-kind support from NASEMSO, NAEMSP and ACEP.