This document discusses guidelines for responding to opioid overdoses, including: - 2015 CPR guidelines recommended compression-only CPR for laypeople responding to overdoses, as ventilations can be a barrier to initiating lifesaving efforts. - Naloxone programs train individuals to administer the opioid-reversing drug to overdose victims, as simple CPR often does not work for opioid overdoses. - European guidelines from 2015 still recommend explaining protocols for overdose response in plain language.

1. See next page Dr. Vaillancourt [below] wrote 2015 CPR guidelines Dr.
Morrison wrote 2010 CPR 2010 guidelines correct 2015 wrong and
misleading.
2015 ILCOR Part 3 Adult Basic Life Support and Automated External
Defibrillation
See page 5 'Opioid Overdose Response Education' My comments
hyperlink BLS 891
http://circ.ahajournals.org/content/132/16_suppl_1/S51.full.pdf+html
Hyperlink BLS 891 read my comments and response to Michael Dailey
[2010 guidelines found here]
https://volunteer.heart.org/apps/pico/Pages/PublicComment.aspx?q=891
2015 AHA Part 10 'Special Circumstances of Resuscitation'
http://circ.ahajournals.org/content/132/18_suppl_2/S501.full.pdf+html
See Part 10.3: p.504 'Cardiac or Respiratory Arrest Associated With
Opioid Overdose'
Read hyperlink ALS 441
https://volunteer.heart.org/apps/pico/Pages/PublicComment.aspx?q=441
Read hyperlink BLS 891
https://volunteer.heart.org/apps/pico/Pages/PublicComment.aspx?q=891
Europe the correct protocol still expressed in plain English
2015 European Resuscitation Council Guidelines for Resuscitation
Section 4. Cardiac arrest in special circumstances TOXINS p165
http://www.cprguidelines.eu/assets/downloads/guidelines/S0300-
9572(15)00329-9_main.pdf
All consensus for OD found here
https://jgarythompson.wordpress.com/2015/08/11/agnotology/

2. From Christian Vaillancourt 01/16/14 at 11:14 PM
To Gary Thompson
I still do not fully understand your objection to this program.
Not sure we have this in Ottawa, but naloxone programs such as this
one have been implemented to save the lives of opioid addicts who
overdose.
I believe the naloxone is meant to be administered quickly by a fellow
addict or case worker or family member trained to do so.
Many such patients die in alleys with no case at all, and simple CPR
will not work in the case of an opioid OD.
Perhaps best to contact a cardiac arrest champion from Toronto if you
are looking for support with some of your objections...have you tried
Dr. Laurie Morisson?
Christian
From Christian Vaillancourt 01/08/14 at 1:56 PM
To Gary Thompson
Most recent resuscitation guidelines (attached) moved to recommend
compression-only CPR for citizen (not for health care professionals)
mostly because it was perceived to be one of the major barrior for
people to initiate CPR…it is also the most difficult part of the
technique to learn.
For witnessed arrests (those having a cardiac arrest with immediate
CPR initiation), since victims already have some oxygen in their lungs
that can passively be absorbed, another argument is that any time
spend doing ventilations is time lost circulating that oxygen with chest
compressions.
In the case of overdoses and children cardiac arrests, the etiology is
commonly a respiratory arrest.

3. Although they would be most likely to benefit from ventilations, once
again – barrier to CPR initiation (reluctance to do so) favor an
approach encouraging chest compressions alone until professional
help arrives.
A few very large studies also seem to support this strategy (no
difference in survival comparing chest –compression alone to
traditional CPR)
Hope this answers some of your questions?
Christian Christian Vaillancourt MD, MSc, FRCPC, CSPQ
Associate Professor, Department of Emergency Medicine
Senior Scientist, Ottawa Hospital Research Institute
Research Chair in Emergency Cardiac Resuscitation, University of
Ottawa
Associate Medical Director, Regional Paramedic Program for Eastern
Ontario
From Christian Vaillancourt 01/07/14 at 7:32 AM
To James Thompson
Thank you for this information Mr. Thompson, but it would help me
respond if I understood your concern better.
Are you concerned with the naloxone program described, or with the
recommendation for compression-only CPR?
Christian
On Jan 7, 2014, at 2:28 AM,
"James Thompson" <jgary.thompson@mail.utoronto.ca> wrote:
Dr. Vaillancourt:

4. Toronto Public Health is doing a live human study, teaching the
general public chest compressions only for poisoning (drug OD). See
attached CJPH 2013;104(3)e200-4
Omitted from the article Signs & Symptoms of opioid poisoning. See
attached from the training
literature www.instantpresenter.com/ohtn/E956D7808049 Slide 31.
I know of deaths 14 yr. old juvenile onset diabetes case; 70 yr. old
unconscious choking victim plus poisoning (drug OD)
deaths. Responders were doing as instructed, unconscious, cyanotic,
laboured breathing give chest compressions only?
Any comment would be appreciated, I am at a loss understanding
this practice.
Thank You & Remember the Mysteries
Gary Thompson