Chapter 20
Drug and Alcohol Emergencies
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CHAPTER
Prehospital Emergency Care, 8th Ed.
Mistovich/Karren/Hafen
Topics
20
Drug and alcohol emergencies
Assessment and care
Managing a violent drug or alcohol
patient
Enrichment
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Introduction
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Drugs and alcohol are abused by many
people, in a variety of ways. Additionally, it is
a widespread finding present throughout all
levels of society.
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Drug and Alcohol Emergencies
20
Drug and alcohol terms:
– Drug abuse
– Drug overdose
– Drug withdrawal
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Assessment and Care
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Assessment and care: scene size-up
– Ensure scene safety
– Note any actual or potential weapons
– Take BSI precautions
– Scan for evidence of drug or alcohol abuse
– Try to identify the drug(s) involved
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Assessment and Care
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Assessment and CARE: INITIAL ASSESSMENT
– Form a general impression
– Take cervical spinal precautions as needed
– If needed, open the airway manually and assess for
patency
– Assess next for breathing adequacy or inadequacy;
utilize high flow oxygen
– Assess circulatory status
– Prioritize the patient’s clinical condition
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Prehospital Emergency Care, 8th Ed.
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Assessment and Care
20
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CHAPTER
Prehospital Emergency Care, 8th Ed.
Mistovich/Karren/Hafen
Assessment and Care
20
Indications of a “high priority” patient
© 2008 by Pearson Education, Inc.
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CHAPTER
Prehospital Emergency Care, 8th Ed.
Mistovich/Karren/Hafen
Assessment and Care
20
Indications of a “high priority” patient
© 2008 by Pearson Education, Inc.
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Prehospital Emergency Care, 8th Ed.
Mistovich/Karren/Hafen
CHAPTER
Assessment and Care
20
Indications of a “high priority” patient
© 2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey
CHAPTER
Prehospital Emergency Care, 8th Ed.
Mistovich/Karren/Hafen
Assessment and Care
20
Indications of a “high priority” patient
© 2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey
CHAPTER
Prehospital Emergency Care, 8th Ed.
Mistovich/Karren/Hafen
Assessment and Care
20
Indications of a “high priority” patient
© 2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey
Prehospital Emergency Care, 8th Ed.
Mistovich/Karren/Hafen
CHAPTER
Assessment and Care
20
Focused history and physical exam
– History and physical exam
– Baseline vitals
– SAMPLE history
Responsive patient
Unresponsive patient
Needle track marks on
the extremities—a sign
of injected-drug use.
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Assessment and Care
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Focused history and physical exam
– “Huffers”
– “Pharming party”
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Assessment and Care
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Signs and symptoms
–
–
–
–
–
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CNS stimulants
CNS depressants
Narcotics
Hallucinogens
Volatile inhalants
Prehospital Emergency Care, 8th Ed.
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Assessment and Care
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Emergency medical care
– Establish and maintain an airway
– Ventilate if needed, apply oxygen
– Position the patient
– Maintain body temperature
– Assess BGL
– Use restraints when necessary
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Assessment and Care
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Detailed and ongoing examination
– Detailed exam enroute, time and condition
allowing
– Ongoing exam completed according to
patient acuity
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Managing a Violent Patient
20
Managing a violent drug or alcohol
patient
– Use the talk-down technique for those
experiencing a “bad trip”
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Enrichment
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Drug withdrawal
– Common to those people whose drug use
has led to a tolerance, which means they
need a larger amount of drug for the same
effect
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Drug withdrawal
– Signs and symptoms of drug withdrawal
usually begin about the time the next dose
is needed
– Symptoms peak at 48–72 hours
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Alcoholic syndrome
– This syndrome results from true addiction
to alcohol as the patient’s drinking problem
progresses over time
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Alcoholic syndrome
– Alcoholics are prone to many common
illnesses
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Alcoholic syndrome
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Withdrawal syndrome
– Occurs after a period of abstinence, or
inadequate consumption given their
physiological dependence
– Occurs in 4 stages
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Enrichment
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Enrichment
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Enrichment
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Delirium Tremens (DTs)
– Severe, life threatening condition, with a 5–15%
mortality rate
– Occurs 1–14 days following last drink, but most
commonly presents within 2–5 days
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Special considerations
– PCP
– Cocaine
– Huffing
– Methamphetamines
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Prehospital Emergency Care, 8th Ed.
Mistovich/Karren/Hafen