Not Breathing

If the person is not breathing normally (i.e. you have not detected 1 or 2 breaths/breathing in the casualty during a 10 second assessment):[1,2]

  1. Call 999 immediately and ask for an ambulance,[2] explaining that the casualty is UNCONSCIOUS AND NOT BREATHING NORMALLY
  2. Give basic life support by giving 30 chest compressions and attempting 2 rescue breaths if possible[2]
  3. Give 0.4ml Prenoxad Injection (naloxone hydrochloride 1mg/ml solution for injection):[2]
    • Open and assemble Prenoxad Injection
    • Hold the syringe like a pen
    • Inject the casualty with the first dose of Prenoxad (0.4ml). The needle should be inserted into the casualty’s outer thigh or upper arm muscle, straight through clothing if required
    • Withdraw the needle from the casualty's outer thigh or upper arm muscle and put the syringe (with the needle still attached) back into the 'cradle' in the Prenoxad Injection case. It will fit into the cradle even with the needle attached[3]
  4. If the casualty is still not breathing normally, give 3 more cycles of 30 chest compressions and 2 rescue breaths followed by one dose of 0.4ml Prenoxad Injection. Inject Prenoxad Injection following the same process and using the same needle as before. Repeat this as many times as necessary until:[2]
    • The casualty starts breathing normally
    • The ambulance arrives
  5. When the casualty is breathing normally move them to the recovery position, lying on their side, mouth open and pointing towards the ground. Stay with the casualty and continue to monitor their breathing[2]


  1. NHS Choices. First aid: after an incident. Page last reviewed November 2018. VIEW
  2. Prenoxad Patient Information Leaflet. VIEW
  3. NHS Lothian & Glasgow, Raigmore Hospital and Scottish Drugs Forum. National naloxone programme. APS Group Scotland DPPAS11546. 2011.