4th update: 19th June 2020

Given the risks of both opioid overdose and coronavirus, the Public Health Agency has provided the following advice/guidance for anyone who may potentially administer naloxone and give Basic Life Support:


Current CPR advice from the NHS is followed by service-providers when administering naloxone. 

CPR and COVID-19 from Resuscitation Council UK

The advice in both documents (in the absence of PPE) is essentially to perform compression only CPR, without rescue breaths or mouth-to-mouth ventilation and not to listen or feel for breathing by placing your ear and cheek close to the patient’s mouth.

 National advice /guidance on infection prevention and control 

Up to date advice please see the PHA website which includes advice for employers, employees and businesses

As I am sure you will appreciate this is a very fluid situation with advice liable to change on a daily basis, but the website is updated daily to reflect any change in advice.’

  • The advice is to perform breathing checks visually only (i.e. not with your ear and cheek to the casualty’s face). Place a cloth over the mouth and nose of the casualty then observe any movement of it and the chest for 10 seconds from a few feet away.
  • If CPR is required that unless you are wearing PPE and using a pocket resuscitation device, you should give chest compressions only.
  • If you do give compressions only, make sure the cloth remains over the mouth and nose as you do so. Naloxone should be administered if there are signs of opioid overdose.

There are no changes to the advice on administering naloxone

  • It is also worth remembering that the majority of people who are still alive but suffering an overdose, are still breathing normally and therefore do not require CPR.
  • These casualties should be put into the recovery position rather than given CPR, with naloxone administered at two minute intervals. Try to reassess if the person is still breathing normally by watching the side of the chest wall move, doing this every minute.
  • As the casualty regains consciousness place a PPE mask over their mouth and nose. Abrupt withdrawal is brought on by administering naloxone to an opioid dependent person. Sneezing is a symptom of abrupt withdrawal.
  • A PPE mask will reduce the spread of droplets expelled by sneezing, and therefore limit the potential for COVID-19 transmission.

The wearing of latex free disposable gloves and other PPE where available is strongly encouraged.

After dealing with the casualty wash your hands thoroughly and change any PPE you were wearing at the time.

If you have any queries please do not hesitate to get it touch at [email protected]