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Get the free Naloxone Kit usage formAlberta Health Services

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NALOXONE KIT USAGE Forms survey collects information about how people are responding to opioid poisonings with Community Based Naloxone Kits. The survey is not linked to your name or personal health
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How to fill out naloxone kit usage formalberta

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How to fill out naloxone kit usage formalberta

01
Obtain a naloxone kit from a pharmacy or local harm reduction program.
02
Familiarize yourself with the contents of the naloxone kit, which typically includes naloxone vials or nasal spray, gloves, alcohol swabs, and instructions.
03
Be prepared to recognize the signs of an opioid overdose, such as unconsciousness, pinpoint pupils, and slow breathing.
04
In the event of an opioid overdose, administer naloxone according to the instructions provided in the kit.
05
Stay with the individual who has overdosed and continue to monitor their breathing and responsiveness until emergency medical help arrives.

Who needs naloxone kit usage formalberta?

01
Individuals who are at risk of experiencing or witnessing an opioid overdose, such as those who use opioids themselves, or their friends and family members.
02
First responders, healthcare professionals, and other individuals who may come into contact with individuals experiencing an opioid overdose.
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Naloxone kit usage form in Alberta is a form that tracks the usage and distribution of naloxone kits for opioid overdose reversal.
Healthcare providers, pharmacies, and organizations distributing naloxone kits are required to file naloxone kit usage form in Alberta.
The form requires information such as the number of naloxone kits distributed, the dates of distribution, the location of distribution, and any naloxone use or reversals.
The purpose of naloxone kit usage form in Alberta is to monitor the deployment and effectiveness of naloxone kits in opioid overdose situations.
Information such as the number of kits distributed, dates of distribution, locations of distribution, and any naloxone use or reversals must be reported.
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