Our tripsitters and therapists are currently being trained to provide first aid in case of accidents. In this blog, I will write down some findings to provide a framework for ourselves and others regarding what to do in the event of accidents during psychedelic sessions.
How to respond to skin wounds
If water is available:
If no water is available:
The skin around a small wound can be effectively cleaned with a skin disinfectant based on chlorhexidine or alcohol 70%.
Applying roofing felt
A dressing consists of a sterile gauze pad for the wound, usually wrapped in a slightly elastic bandage.
A 'regular plaster' is in principle also just a dressing.
Goal:
Execution:
Applying a quick bandage
Goal:
Execution:
Adhesive strips for cuts
Goal:
Execution:
Bandaging a skin wound with an object
Execution:
Bleeding
In the case of severe or active (external) bleeding, the skin and underlying tissues are damaged, and (a large amount of) blood flows from the wound. If someone loses too much blood, this can be a life-threatening situation. It is therefore important to react immediately and correctly to limit blood loss while awaiting the arrival of emergency services.
What do you observe?
Bleeding from the ear: keep the ear clear so that blood can drain out. Do not apply pressure.
An internal hemorrhage is a bleeding in which blood vessels inside the body are damaged, but the bleeding does not exit the body. Some organs (for example, the heart, liver, spleen, or kidneys) are very richly supplied with blood vessels and can lose a lot of blood if they are damaged.
The severity of an internal hemorrhage is extremely difficult to assess because you do not see any blood. If the victim goes into shock, he has already lost a lot of blood.
There are various causes that can lead to shock. The body's reaction to sudden blood or fluid loss is shock, such as in cases of internal bleeding, heart failure, and circulatory arrest.
Allergic reactions can also cause symptoms of shock. In the event of sudden blood or fluid loss, the body attempts to limit the consequences of the loss. The heart beats faster to circulate the remaining blood, and breathing accelerates. The blood is directed to the organs necessary for survival: the heart, lungs, and brain.
What do you observe?
What are you doing?
A (wound) compression bandage consists of applying pressure with an elastic bandage, exerting pressure on the wound site to stop the bleeding. Ensure that the bandage is tight enough to stem the bleeding but does not constrict full circulation. If the skin around the bandage turns blue or becomes numb, loosen the bandage slightly but do not remove it completely.
Goal:
Execution:
In case of severe or active bleeding and/or shock:
It is not a problem if 112 is called instead of the GP or the GP emergency post, or vice versa. The healthcare professionals ensure the appropriate assistance is provided.
Nosebleeds
A nosebleed is almost always harmless. Picking the nose or a blow to the nose can damage a blood vessel, causing bleeding. Small children sometimes put things in their noses, such as a small stone, and this can cause a small wound. The mucous membrane on the inside of the nose is thin and quite delicate.
What do you observe?
What are you doing?
Many small blood vessels run through the nasal mucosa. After a cold, due to scab formation, or nose picking, this area can easily start to bleed, resulting in a nosebleed. A nasal spray containing corticosteroids can also cause a nosebleed. Nasal packing may only be inserted with the permission of a doctor.
Choking
Choking can occur if, for example, a candy, a piece of food, or another object goes down 'the wrong throat'. The wrong throat is the windpipe. The airway is then no longer freely permeable.
A foreign object can partially or completely obstruct the airway. If the airway is partially obstructed, the victim will still cough and breathe audibly and clutch at their throat. In the event of a complete airway obstruction, the victim will make silent coughing movements, will barely or not be able to breathe, will turn blue, and will eventually lose consciousness.
What do you observe?
What are you doing?
Suffocation occurs when a person's airway is blocked. In the case of severe choking or suffocation, the victim cannot speak, coughs silently, and can barely or not breathe at all. Later, the face may turn blue and the victim may lose consciousness. The victim is unable to breathe at all. There is panic and agitation. This is a life-threatening situation! If the victim chokes or is in danger of suffocating, try to clear the airway.
What do you observe?
Strikes on the back and belly thrusts execution
If the first responder cannot stand behind the victim due to their size, chest thrusts can also be performed from the front, with the victim leaning against the wall with their back. This technique can also be applied to disabled victims who are wheelchair-bound. Apply the brakes to the wheelchair and, if possible, position the back against the wall so that it cannot tip over.
Call 112:
It is also possible that internal organs are damaged by abdominal thrusts. The victim must therefore always be examined after the incident.
Neck and spinal injury
Neck and spinal injuries occur in an accident involving a sudden impact on the body, for example in a car accident or a fall down the stairs.
Take into account a possible neck or spinal injury if:
In the case of an unconscious accident victim with a high risk of neck or spinal injury, keep the airway clear if necessary by applying the chin lift.
Goal:
Execution:
Concussions
Mild traumatic brain injury, or a concussion, is the result of a blow or impact to the head. The skull is usually strong enough to protect the head against a fall, impact, or blow. Nevertheless, it is possible for the skull itself or the brain to be damaged. In the case of mild traumatic brain injury, such as bumping the head or falling from a low height, the injury will usually be limited to a bump or wound on the head.
Sometimes symptoms only appear in the first days or weeks after the accident. Sometimes the loss of consciousness after the accident is so brief that it goes unnoticed, yet there are strong indications of head injury, such as drowsiness, lethargy, and headache.
Children require extra attention. After a seemingly minor accident, whether or not involving loss of consciousness, a child may only become drowsy, lethargic, and restless later.
What are you doing?
Call 112 if:
Call the GP or the out-of-hours GP service in case of:
It is not a problem if 112 is called instead of the GP or the GP emergency post, or vice versa. The healthcare professionals ensure the appropriate assistance is provided.
Poisoning
Hazardous substances can exist in various forms: as a solid, a liquid, and a gas. These hazardous substances can enter the body through ingestion, inhalation, skin contact, or injection. With some hazardous substances, the body reacts within a few seconds, while with others, it takes hours or days.
What do you observe?
Dishwasher tablets and button cell batteries pose a particular danger to children. Button cell batteries are becoming increasingly common in households, for example in remote controls, toys, electric candles, and tea lights. If a child swallows a button cell battery, it usually passes through the gastrointestinal tract without problems. However, in a small percentage of cases (<1%), the battery gets stuck and causes local tissue damage. If you suspect that a child has swallowed a battery, always consult your GP.
In case of burns caused by contact with hazardous substances, rinse the skin immediately, preferably with rinsing solution (according to the instructions for use or safety data sheet), or otherwise with lukewarm water. You can read how to do this on the next page.
A characteristic of (slow) CO poisoning is that health complaints, such as fatigue, disappear during a stay away from home. However, upon returning home, the body absorbs too much carbon monoxide again and the symptoms return. Ultimately, carbon monoxide can be fatal.
What do you observe?
What are you doing?
Call 112 if:
Call the GP or the out-of-hours GP service in case of:
Sometimes the symptoms of someone with chest pain are not always clear; there is initially moderate chest pain and a feeling of discomfort. The cause of chest pain can range from stress-related symptoms to a heart attack. The victim may say that nothing is wrong, but does need help quickly. Nevertheless, err on the side of caution and call 112 or have someone call 112.
What do you observe?
In the elderly and diabetics, a heart attack can occur without the aforementioned symptoms. The victim may also experience unexpected pain, for example in the upper abdomen, high in the back, or in one or both arms. The victim may also suffer from sudden fatigue and/or (acute) shortness of breath.
If the victim is short of breath, you can have the victim lie with their upper body slightly elevated. In case of fainting and dizziness, raise the legs slightly (jackknife position). If the victim does not wish to do this, allow them to assume a preferred position themselves.
Stroke
A stroke is an umbrella term for a TIA (Transient Ischemic Attack), a cerebral infarction, or a cerebral hemorrhage. A stroke means an acute disruption of the blood supply to the brain, which is often accompanied by neurological deficits. It is not visible from the outside which type you are dealing with. It is more important to quickly recognize the signs and act immediately.
What do you observe?
Recognizing a stroke quickly:
Call the GP or the out-of-hours GP service: