If someone is acutely intoxicated from the effects of volatile substance use (VSU) there is the possibility of overdose. This can develop from the toxic effects of the substance/s used, mixing with other drugs (particularly other central nervous system depressants such as alcohol, benzodiazepines), having a low tolerance and not seeking help at the first signs that something is wrong.
A person recovering from acute VSU intoxication should be kept safe and be watched until they have fully recovered. If possible, monitor the person in a clinical setting throughout the period of acute intoxication (approximately 2-4 hours if recovery is uncomplicated or longer if recovery is delayed) even if they regularly use volatile substances. If it is not possible to transfer the person to a medical service, watch them closely and call emergency services if they become unconscious, have a seizure or if their condition becomes worse in any way (National Health and Medical Research Council, 2011).
The person should be provided with immediate medical assistance if they:
- are injured
- are unconscious or seem to be losing consciousness
- have collapsed
- are not breathing normally
- have a seizure (fit).
(National Health and Medical Research Council, 2011)
Police can assist under the Protective Custody Act (2000) which allows them to take an intoxicated person, who does not require emergency treatment or hospitalisation, to a safe place or place them into protective custody until a parent, guardian or responsible person has been located. It also allows police to confiscate intoxicating substances from juveniles.
If the person is unconscious, apply first aid immediately:
D – Danger
Check for danger to yourself (first aider), bystanders and the casualty. Remove anything dangerous near them (i.e. matches/lighter) and make sure there is plenty of fresh air.
R – Response
Check for a response. Ask their name and squeeze their shoulders. No response indicates that they are unconscious so it is important to get help as quickly as possible. If there is a response, seek permission to help them and monitor breathing and response.
S – Send for help
Call triple zero (000) for an ambulance (or call for the local health worker if no ambulance). If there is someone else nearby, ask them to make the call. If you are by yourself, place the person on their side (recovery position) and then call for help.
A – Airway
Clear the airway - place one hand on the forehead and two fingers on the chin. Open the mouth and check for foreign material or obstruction. If foreign material or obstruction present, roll them on to their side (recovery position) and clear their airway of anything that may be blocking it. Then move onto their back again.
B – Breathing
Check breathing. Look, listen and feel for 10 seconds for 2 normal breaths in 10 seconds. If breathing, place them in the recovery position and monitor their breathing. Stay with them until medical help arrives. If they are not breathing, commence CPR.
C – Cardio-pulmonary resuscitation (CPR)
Start CPR - 30 chest compressions : 2 breaths. Continue CPR until help arrives or the person starts to breath normally.
D – Defibrillation
If a defibrillator is available, turn it on and follow the voice prompts. Continue CPR except when the defibrillator delivers a shock and until medical help arrives.
(St John Ambulance Australia, 2015)