1. First Aid for Colleges and Universities 10 Edition Chapter 15 © 2012 Pearson Education, Inc. Drug and Alcohol Emergencies Slide Presentation prepared by Randall Benner, M.Ed., NREMT-P

2. Learning Objectives Determine weather an emergency is drug or alcohol related. Determine whether a drug- or alcohol-related emergency is life threatening. List the signs and symptoms of acute alcohol intoxication. List the signs and symptoms of withdrawal syndrome. Identify assessment techniques to use in drug and alcohol emergencies. © 2012 Pearson Education, Inc.

3. Learning Objectives Describe and demonstrate how to manage: –Drug or alcohol related emergency –A violent victim of a drug overdose –An overdose victim Describe and demonstrate the talk-down technique. Describe four classifications of illegal drugs. Describe the care for victims who have taken a drug. © 2012 Pearson Education, Inc.

4. Introduction Alcohol is the most abused drug in the United States. Drug abusers, in general, are susceptible to certain injuries, illness, and infectious diseases. Many medical emergencies involve drug overdoses. The First Aider will need to determine when an emergency is related to drugs and/or alcohol, and provide appropriate care until EMS arrives. © 2012 Pearson Education, Inc.

5. Determining Whether an Emergency Is Drug or Alcohol Related Inspect area for evidence of drug use. Look in patient’s mouth for pills/tablets. Smell the victim’s breath for odors. Interview family, friends, witnesses. Assess the patient’s ability to perform simple motor tasks. © 2012 Pearson Education, Inc.

6. Determining Whether an Emergency Is Life Threatening The following may indicate a life threatening emergency: –Victim is unconscious –Victim has breathing difficulties –Victim has abnormal or irregular pulse –Victim is vomiting while not fully conscious –Victim has convulsions or seizures –Victim has fever © 2012 Pearson Education, Inc.

7. Determining Whether an Emergency Is Life Threatening © 2012 Pearson Education, Inc.

8. Alcohol Emergencies General alcohol emergency considerations –Acts like a central nervous system depressant –Is absorbed within minutes after drinking –Can result in alcoholic syndrome –Alcoholics may have “blackout periods” –Abstinence from alcohol often causes withdrawal symptoms © 2012 Pearson Education, Inc.

9. Alcohol Emergencies Acute intoxication depends on amount consumed Acute intoxication effects include –Drowsiness –Disordered speech and gait –Violent or aggressive actions –Destructive or erratic behavior –May mimic hypoglycemia symptoms © 2012 Pearson Education, Inc.

10. Alcohol Emergencies Binge drinking –Drinking with the intent of becoming drunk –Common on college campuses –Often involves mixing of alcoholic beverages –Common effects include stuper, unresponsiveness, and vomiting –Can result in death from acute intoxication © 2012 Pearson Education, Inc.

11. Alcohol Emergencies Withdrawal syndrome –Occurs with a cutback in alcohol consumption by an alcoholic –Four basic stages Stage 1: Occurs within 8 hrs – symptoms are minimal Stage 2: Occurs within 8-72 hrs – worsening of Stage 1 Stage 3: After 48 hours – major seizures Stage 4: onset of delrium tremens (DTs) © 2012 Pearson Education, Inc.

12. Alcohol Emergencies Withdrawal syndrome symptoms can mimic psychological disorders –Insomnia, disorientation, confusion, hallucinations –Weakness, nausea, and vomiting –Fever or seizures –Rapid pulse –Anorexia © 2012 Pearson Education, Inc.

13. Alcohol Emergencies Delirium Tremens (DTs) can be life threatening Can last several days, and are characterized by: –Confusion, memory loss –Restlessness, tremors, insomnia –Fever, dilated pupils –Profuse sweating –Nausea, diarrhea –Hallucinations © 2012 Pearson Education, Inc.

14. Assessment and Management Observation and assessment –Determine the severity of the intoxication. –Assess the patient’s mental status. –Obtain a history from the patient or witnesses. –Assess the patient for any other injuries or symptoms not obviously evident (e.g., hidden trauma or medical conditions). © 2012 Pearson Education, Inc.

15. Assessment and Management Activate EMS immediately if any of the following are present. –Central nervous system functions are impaired or slowed. –Tremors or seizures –Withdrawal accompanied by pain –Slow or absent breathing –Visual, mental, or muscular disturbances –Gastrointestinal problems such as vomiting or bleeding –Disinterested behavior and loss of memory © 2012 Pearson Education, Inc.

16. Assessment and Management Managing a drug or alcohol crisis –Ensure your own safety, take personal precautions. –Provide the patient with a “reality base”. –Use appropriate nonverbal support; express concern. –Encourage communication. –Foster confidence. © 2012 Pearson Education, Inc.

17. Assessment and Management Managing a violent drug or alcohol victim –Recognize warning signs for potential violence (agitation, excessive energy, verbal threats, violent motions). –Activate EMS and police if needed. –Restrain only when needed and you can do so safely. © 2012 Pearson Education, Inc.

18. Assessment and Management Managing a violent drug or alcohol victim –Do not invade the patient’s “personal space.” –Use a calm and reassuring tone of voice. –Do not block the victim’s “escape” path. –Move dangerous objects out of reach. © 2012 Pearson Education, Inc.

19. Assessment and Management Managing a violent drug or alcohol victim –If the patient becomes violent Leave the scene, especially if weapons present. Do not attempt to restrain unless necessary and you can do so with others, safely. Providing appropriate care –Stabilize airway, breathing, and circulation. –Provide specific treatment for any concurrent trauma or medical illness. © 2012 Pearson Education, Inc.

20. Assessment and Management Managing an overdose –Maintain your personal safety. –Establish and maintain an airway. –Provide artificial ventilation, if necessary. –Place patient in recovery position. –Monitor body temperature and keep within normal limits. –Treat for shock, if present. –Reduce external stimuli. –Explain all steps as you complete them; speak calmly and confidently. –Activate EMS. © 2012 Pearson Education, Inc.

21. Assessment and Management How to perform a “talk-down” technique –Make the patient feel comfortable; establish trust. –Reassure the patient that they are under the effects of drugs. –Identify yourself clearly; state that you want to help. –Help the victim verbalize what is happening. –Repeat simple and concrete statements continuously. –Forewarn victim of what will happen when the drug wears off. –Exercise caution and protect yourself. –Do not attempt a “talk down” with PCP users. © 2012 Pearson Education, Inc.

22. Drugs of Concern Numerous illegal drugs and prescription drugs are abused and can become addictive, including –Hallucinogens –Stimulants –Depressants/narcotics –Other illicit drugs (Rohypnol, ecstasy, GHB) © 2012 Pearson Education, Inc.

23. Drugs of Concern First aid care for drug use and overdose –Assure your own personal safety. –Monitor and support airway, breathing, and circulatory functions. –Consider possible use of talk-down technique. –Prevent further injury of the victim to themselves. –Activate EMS. –Monitor vital signs until EMS arrives. © 2012 Pearson Education, Inc.

24. Summary Drug abuse symptoms may mimic other illnesses or disease states. The First Aider may be called to care for a patient experiencing symptoms of drug abuse, withdrawal, or DTs. Always ensure that the airway, breathing and circulatory function are supported until EMS arrives. Always secure your own safety and take necessary personal precautions. © 2012 Pearson Education, Inc.