Online Program

Naloxone Administration by EMS Personnel in Oklahoma: Patient Demographics and Temporal Patterns

Monday, November 2, 2015

Johnnie Gilpen Jr., MS, NREMT-I, Emergency Systems, Oklahoma State Department of Health, Oklahoma City, OK
Kenneth Stewart, PhD, Emergency Systems, Oklahoma State Department of Health, Oklahoma City, OK
Martin Lansdale, MPH, Emergency Systems, Oklahoma State Department of Health, Oklahoma City, OK
Yang Wan, PhD, Emergency Systems, Oklahoma State Department of Health, Oklahoma City, OK

Unintentional poisoning is the leading of injury death in Oklahoma. Unintentional poisoning mortality rates increased five-fold from 1999 to 2013 (From 3.8 to 19.1 per 100,000 population respectively). From 2007 through 2012, 87% of unintentional poisoning deaths involved prescription drugs, of which 69% were opioid analgesics. In 2013, Oklahoma House Bill 1782 provided statutory language to allow first responders the authority to administer without prescription, opiate antagonists when encountered an individual exhibiting signs of an opiate overdose to help decrease opiate-related mortality. The Emergency Medical Service (EMS) protocol changes representing the new statutory changes went into effect June 4, 2014.


Emergency service calls (ESC) from January 1, 2011 to June 3, 2014 reported to the Oklahoma State Department of Health's Oklahoma EMS Information System(OKEMSIS) were analyzed to identify patients who received naloxone. Demographics and temporal patterns associated with EMS naloxone administration were derived. Results were compared to opiate-related overdose deaths during the same period.


Among the 1,782,646 reported ESCs, naloxone administration was documented 13,064 times (0.7%). Naloxone administration was highest among Caucasian females in the 50-54 year age group. Results suggest a bimodal monthly temporal pattern with peaks in March and July. Day of the week results demonstrate the highest administration frequency on Fridays and Saturdays. Overall, administration peaked at 6 pm.


ESC data provide baseline data on naloxone administration by EMS personnel to help identify the impact of the expansion of naloxone use beyond paramedic-level EMS to all first responders.

Learning Areas:

Clinical medicine applied in public health
Other professions or practice related to public health
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related research

Learning Objectives:
Identify baseline data for naloxone administration by emergency medical services (EMS) providers in Oklahoma prior changes to the state’s EMS protocols dictated by the changes to the Administration of opiate antagonists (§ 63-1-2506.1) regulations.

Keyword(s): Prescription Drug Abuse and Misuse, Emergency Medical Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the statistical research specialist on multiple projects that have focused on the epidemiology of prehospital emergency care with in Oklahoma including naloxone administration. My scientific interests have been to describe the epidemiology of prehospital emergency care and associated disparities as well as to develop public health strategies to increase the quality of prehospital emergency care in Oklahoma.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.