Project Archive

Naloxone Evidence-Based Guidelines


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), created 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.

A model protocol for opioid poisioning/overdose was created based on the evidence-based guideline and is available at Model EMS Protocol Relating to Naloxone Administration by EMS Personnel.

In addition to the evidence-based guideline and protocol, the project produced a training module that is available Naloxone EBG Training Module Slides.

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.

Kenneth Williams, MD, FACEP, FAEMS – Principal Investigator
Representing the National Association of State EMS Officials
Dr. Kenneth A. Williams is is the EMS Division Director at Brown University, Medical Director for LifePACT, Rhode Island’s Critical Care transport program, and an active member of the USCG Auxiliary. He founded the ACGME-approved EMS Fellowship at Brown, and is the Program Director. Dr. Williams has been the Medical Director at the Rhode Island Department of Health Center for EMS since 1997, and presently chairs the NASEMSO Medical Directors Council.

John Lyng, MD, EMT-P, FACEP, FAEMS – Co-Investigator
Representing the National Association of EMS Physicians
Dr. John W. Lyng is co-head Medical Director for North Memorial Health Ambulance & Air Care and an Emergency Physician at North Memorial Health Hospital in Minneapolis, Minnesota. He is one of the initial 200 physicians in the United States to achieve Board Certification in EMS Medicine, a new subspecialty certification established in 2013. His accomplishments as chair of the NAEMSP Standards and Clinical Practices Committee earned him the NAEMSP President’s Award in 2017 for “outstanding contributions in prehospital emergency care and dedication and commitment to the development of quality standards and practice for prehospital medicine.” Dr. Lyng also received the Hennepin County, MN Sheriff’s Distinguished Service Award“ in recognition of dedication to drug abuse prevention and partnership with the Hennepin County Sheriff’s Department” in 2015, for his contributions to community opioid education and curriculum development for first-responder naloxone programs.

Jeffrey Goodloe, MD, NRP, FACEP, FAEMS – Co-Investigator
Representing the American College of Emergency Physicians (ACEP)
Dr. Jeffrey M. Goodloe is the Medical Director for the Medical Control Board, which provides medical oversight for Metropolitan Oklahoma City and Tulsa EMS systems. He is Professor and Section Chief of EMS in the Department of Emergency Medicine at the University of Oklahoma School of Community Medicine. Dr. Goodloe began his EMS career working as an EMT-Basic, EMT-Intermediate, and paramedic for Baylor University EMS and American Medical Transport and has continuously maintained certification as a paramedic since 1990. He has particular knowledge in designing in-house EMS educational programs and, for many years, was the only physician in the United States credentialed as an on-site reviewer for the Commission on Accreditation of Ambulance Services and as an organization and course reviewer for the Continuing Education Coordinating Board for Emergency Medical Services. Dr. Goodloe is currently the Chair of the ACEP’s EMS Committee.

Other Panel Members

James Gasper, PharmD, BCPP
Dr. Gasper is a psychiatric and substance use disorder pharmacist for the California Department of Health Care Services. His present initiatives include expanding access to treatment for substance use disorders, implementing the availability of naloxone, and improving the safety of opioid analgesics. Beyond his work for the Department, he serves as a consultant for the UCSF Clinician Consultation Center Substance Abuse Warmline and as a clinical pharmacist for the El Dorado Community Health Center, a FQHC in the Sierra Foothills. Dr. Gasper has been an investigator on several NIH-sponsored research grants, including the use of naloxone for opioid safety, smoking cessation in opioid dependence treatment, and the pharmacological management of methamphetamine addiction. Dr. Gasper received his Doctor of Pharmacy from the University of Colorado and completed residency training at the Denver Veterans Affairs Medical Center and the University of California, San Francisco.

Richard Hale
Richard Hale is an accomplished software development director and architect with over 15 years of diverse industry experience, with an emphasis on enterprise-relevant business intelligence and large-scale transactional systems development. Since joining ESO Solutions in 2010, Mr. Hale’s primary role has been to expand the health information product portfolio to include world-class system integration and analytics capabilities. As a member of the EMS Compass Technology Developers Group, Mr. Hale collaborated with other software developers to design and test performance measures for EMS.

Vicki Hildreth 
Vicki Hildreth, BA, NREMT, has been the Coordinator for Emergency Medical Services for Children (EMSC) for the West Virginia Department of Health and Human Resources since 2008. She was one of 10 who received the National EMSC Recognition Award for her role in going above and beyond to provide advice, inspiration, and leadership in grant-related matters. Additionally, she has been honored twice within the EMS community for her dedication and commitment to improving healthcare for children. She has worked to form successful partnerships that have resulted in securing funds in excess of $800,000 to continue to improve the healthcare and injury prevention education for children in West Virginia. Ms. Hildreth’s most recent accomplishment was obtaining funding for the development of training to improve the care of newborns with substance exposure and Neonatal Abstinence Syndrome. In Spring 2018, this training will be provided to West Virginia EMS field providers and hospital personnel. West Virginia has been disproportionately affected by the opioid epidemic and consistently leads the nation with the highest rate of drug overdose deaths. See articles from Charleston Gazette Mail: Jan. 29, 2018and Feb. 6, 2018.

Eddy Lang, MD
Eddy Lang, MD, is the Academic and Clinical Department Head and an Associate Professor in the Department of Emergency Medicine, at the Cumming School of Medicine, University of Calgary. He also holds the position of Senior Researcher with Alberta Health Services. He co-chaired the 2007 Academic Emergency Medicine Consensus Conference on Knowledge Translation, which remains an ongoing interest. Dr. Lang is a member of the GRADE working group and has led the development of GRADE-based clinical practice guidelines in pre-hospital care in the United States and is currently engaged in the same activity with the International Liaison Committee on Resuscitation. Dr. Lang is also an award-winning educator, having received recognition at both the university, national and international levels. He also serves as Senior Associate Editor for the Canadian Journal of Emergency Medicine and Associate Editor for ACP Journal Club and the International Journal of Emergency Medicine. He also writes a quarterly column for the Calgary Herald on evidence-based medicine.

Ashish Panchal, MD, PhD
Ashish R. Panchal, MD, PhD is an Associate Professor of Emergency Medicine at The Ohio State University Wexner Medical Center. Dr. Panchal is passionate about improving patient outcomes in the prehospital setting and conducts research focused on prehospital airway management and improving outcomes from cardiac arrest. Dr. Panchal began his career as a researcher completing a Ph.D. in cardiovascular physiology at Case Western Reserve University. Following this, at The Ohio State University College of Medicine, Dr. Panchal completed his medical training and residency. Currently, Dr. Panchal is heavily involved in prehospital care. He is the Director of the Ohio State’s Center for EMS and Fellowship Program Director for the EMS fellowship. Dr. Panchal is also the Research and Fellowship Director for the National Registry of Emergency Medical Technicians and is the EMS Medical Director for Delaware County EMS and Newark Fire Department. Dr. Panchal is a member of the American Heart Association Emergency Cardiovascular Care Scientific Subcommittee, and was a writer for the 2015 AHA Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Tim Seplaki, NRP
Tim Seplaki has been a National Registry Paramedic (NRP) for 20 years, and currently serves as the Data Manager for the New Jersey Department of Health, Office of Emergency Medical Services (EMS). He began his 25-year career in EMS as a volunteer Emergency Medical Technician, before advancing to the level of Flight Paramedic. His responsibilities include the implementation, coordination, and oversight of the electronic Patient Care Reporting and EMS data collection system for New Jersey. Tim also serves as a member of the National Association of EMS Officials (NASEMSO) Data Managers Council and works regularly with the National EMS Information System (NEMSIS). Tim also works closely with the New Jersey State Police Drug Monitoring Initiative (DMI); overseeing and coordinating EMS bio-surveillance data of suspected opioid overdose and Naloxone administration. Additionally, Tim presents regularly throughout the state with members of the DMI on the opioid epidemic and the DMI initiative. He received his bachelor of science degree with a concentration in EMS management from George Washington University.

Sharon Stancliff, MD
Sharon Stancliff, MD is the Medical Director of the Harm Reduction Coalition where she provides training and capacity building services on issues related to drug user health in New York, nationally and internationally. Dr. Stancliff has been working with people who use drugs since 1990 including provision of primary care, drug treatment, HIV care and syringe access. Currently she focuses on opioid overdose prevention through promoting the use of naloxone both directly through education and capacity building with community members, law enforcement and correctional facilities as well as pharmacies. She also works on expanding access to buprenorphine in primary care and in less traditional settings such as syringe exchange programs and emergency departments. Dr. Stancliff graduated from the School of Medicine at University of California at Davis, did her Family Practice residency at the University of Arizona and completed the AIDS Institute-sponsored Nicolas Rango HIV Clinical Scholars Program. She is board certified in Family Medicine, and in Addiction Medicine.

Sgt. Nate Sullivan
Nate Sullivan is a paramedic and EMS Educator for Cherokee County Fire & Emergency Services in suburban Atlanta, Georgia. He is in his 21st year of public safety and served as Paramedic and CCEMT-P on an ambulance prior to being assigned to the Training Division. Nate has experience rural, suburban, and urban settings, and also served as a Paramedic in an Emergency Department and Remote Duty Paramedic in Afghanistan. He is currently the EMT Training Officer and EMS educator responsible for coordination of initial EMT/AEMT courses, creating continuing education content, recruit training and fire training. He is also responsible for development and coordination of many community health programs, including: naloxone administration for Law Enforcement and the Stop The Bleed campaign for the community and school system, and Emergency Medical Services for Children.

Peter Taillac, MD, FACEP 
Dr. Peter Taillac is a Fellow of the American College of Emergency Physicians and a Diplomat for the American Board of Emergency Medicine. He is Board Certified in Emergency Medicine and Emergency Medical Services. Taillac is a Clinical Professor of Surgery in the Division of Emergency Medicine at the University of Utah School of Medicine. He is the State EMS Medical Director at the Bureau of Emergency Medical Services and Preparedness, Utah Department of Health. Peter is also the Medical Director of West Valley City Fire and EMS. Dr. Taillac’s areas of interest and expertise are in EMS (prehospital emergency care) and military and combat medical care, as well as general emergency medicine, with an emphasis on hemorrhage control, cardiac arrest, time-critical diseases, disaster preparedness, and EMS systems development and performance improvement.

Debbie Vass, EMT-P, RN
Debbie Vass is the Director of Quality Initiatives for Paramedics Plus. Debbie has served as the Chief Administrative Officer (CAO) for Sunstar Paramedics from February 2013 to June 2015, and held the position of Director of Clinical Services for nine years prior to that. Her emergency medical services career has spanned over two decades and has primarily focused on ensuring quality patient care throughout all levels of the Sunstar team. A certified paramedic and licensed nurse in the state of Florida, Debbie has also served as an adjunct, non-credit faculty/CME Instructor at St. Petersburg College and has taught Pinellas County Continuing Education Classes to EMTs, paramedics and nurses. She was the proud recipient of the 2008 State of Florida “EMS Nurse” award and is a Florida Governor Sterling Master Examiner. Debbie is currently the president of the Florida EMS Quality Manager Group and has held that position for over three years. In 2015, she served on the Measure Design Group for the NASEMSO EMS Compass Initiative.


For More Information

Mary Hedges, MPA
Program Manager