Emergencies.

What to do in an emergency

If you're with someone who needs medical help, call an ambulance and tell the crew everything you know about the drugs taken, it could save their life. If you have any drugs left, hand them over to the crew as it may help. They won't tell the police (Talk to Frank, 2019).

It may be an emergency if:

The following signs and symptoms are present (not all may be present together),

• Drowsiness, loss of coordination and collapse
• Confusion or hallucinations
• Altered breathing pattern or breathing difficulty
• Mood changes including excitability, aggression or depression
• Pale, cold and clammy skin
• Nausea or vomiting
• Seizures
• Abdominal pain
• Evidence of poisons, containers, smells, etc.
• Tense
• Panicky
• Overheated and dehydrated
• Anxious

How to help

1. Stay calm
2. Assess the patient – are they conscious? If not, place them in the recovery position (see here for instructions).
3. Make sure that their air way is clear and that they won’t choke on their own vomit.
4. Call 999
5. Reassure them – speak in a calm, soothing manner. Sometimes they become agitated, if you feel they pose a risk to themselves or others, call the police.
6. Stay with them.

What to do if they are...

Unconscious/difficulty breathing	Drowsy	Anxious	Overheating
Call an ambulance immediately. Put them in the recovery position. Wait with them until the ambulance arrives.	Sit them in a quiet place. Keep them conscious (don’t scare or shock them). Don’t administer coffee. Don’t put them in a cold bath to keep them awake – this poses a risk of drowning.	Sit them in a quiet and calm room. Keep them away from crowds, bright lights and loud noises. Tell them to take slow deep breaths. Stay with them.	Remove any excess clothing to allow the air to reach the skin and assist with clothing.

What happens in A&E (Talk to Frank, 2019)

In A&E the doctors and nurses will treat your friend as best as they can. This may involve giving an antidote or treatment to counteract the effect of the drugs.

You can help by telling the ambulance crew, the doctors and nurses all you know about what drug(s) your friend had taken, if they’d been drinking, and if your friend has any medical conditions and if there are still some of the drugs left, hand them over. See if you can find out how it was taken as well: swallowed, inhaled or injected as this information will help the emergency services to administer the right support. Look for evidence that might assist the hospital staff with treatment and keep any container, syringe or needle and any vomit to aid analysis and identification.

Providing this information will help them give your friend the right treatment without delay. They won’t tell the police, your friend’s family or others not involved in their clinical care, that your friend has been taking drugs.

What to do if someone overdoses on opiates (Talk to Frank, 2019)

Naloxone is an emergency antidote to opiate overdose. It counteracts the effects of opioid drugs (such as heroin, methadone, morphine, codeine and fentanyl) and reverses the life-threatening effects of an overdose.

If you think someone has overdosed, you need to call an ambulance straight away so that expert help is immediately on its way.

Local services can make naloxone available, alongside training on how to use it, so that it can be supplied to people who might need it, such as drug users, their family and friends.

It’s normally very easy for people to use naloxone if they’ve had simple training. Overdose and naloxone training normally provides advice on:

• how to recognise a possible opioid overdose
• how to check for depressed or absent breathing
• how to put the person in the recovery position and call for an ambulance
• how to use naloxone

It is possible to give too much naloxone too quickly, so any training should give clear advice about building up the dose in stages as needed.

If it looks like the person is not breathing at all, or their heart has stopped, they will need further first aid before the ambulance arrives. The affected person will probably need mouth to mouth resuscitation and chest compressions (CPR). They might still benefit from a naloxone injection, but this mustn’t delay starting the required CPR.

Most overdose situations will need an ambulance to be called, the person put in the recovery position (please see this NHS first aid guide), naloxone injected, and someone to stay with the affected person until professional help arrives.

Naloxone works to reverse opioid overdose for only a short period of time. Even when the naloxone does work first time, you will still need to keep an eye on the person until the ambulance arrives, and during this time you may need to top up the naloxone more than once to keep the person awake and breathing adequately. An ambulance should always be called and someone should stay with the person until the ambulance arrives.

Naloxone: You can get naloxone from certain pharmacies, Jays in Egham high street is a registered Naloxone provider. You can see the list of pharmacies in Surrey which supply Naloxone here.