1. Internship Abstract
Title: 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.
