First aid for trip sitters and psychedelic therapists

Fainting

Fainting is a sudden, brief loss of consciousness caused by a temporary decrease in blood flow to the brain. Fainting can be a reaction to pain, exhaustion, or emotion (for example, fear or seeing blood). It also occurs in victims who stand or sit still for a long time (especially in a warm environment).

What do you observe?

• Weakness and nausea.
• Paleness.
• Sweating and cold skin.
• The victim sees black spots in front of their eyes.
• Loss of consciousness (fainting) and falling.

What are you doing?

If you are certain that you are dealing with a fainting spell (without loss of consciousness):

• Try to prevent fainting by having the victim lie on the ground for 10 minutes.
• If the victim does not recover from lying down, call the GP or the GP emergency post.
• Call or have someone call 112 in case of unconsciousness; put the phone on speakerphone.
• Ensure fresh air and loosen any tight clothing.
• If necessary, raise the legs (30-60 degrees) if it is certain that there no trauma has occurred. Lifting the legs ensures blood flow to the brain and can help to recover faster. The legs should only be lifted if there is no injury.

In the case of a fainting spell, there is often no sudden loss of consciousness. If the victim is lying down, they will quickly regain consciousness and perk up. You do not need to call the GP or the GP emergency department in this case. After all, you have prevented someone from losing consciousness. Once the victim regains consciousness, have them gradually sit up after a while. If the victim starts to feel faint again, lay them flat once more.

Shortness of breath

Shortness of breath (breathing difficulties, including those caused by asthma or COPD) is a feeling of tightness in the chest. Becoming out of breath easily can have many causes, from heart failure to chronic bronchitis / emphysema (COPD). The condition can worsen rapidly.

What do you observe? 

• Difficulty breathing.
• Longer exhalation time than normal.
• Gasping for breath.
• Neck and shoulder muscles move along with breathing.
• Anxiety, restlessness, a rapid heartbeat or palpitations.

What are you doing?

• Call or have someone call 112 in case of severe shortness of breath or rapid breathing combined with a change in skin color and becoming drowsy.
• Call the GP if you have shortness of breath and a fever or appear unwell.
• If a victim is known to have shortness of breath and receives medication via an inhaler, assist the victim. Always let the victim administer their own medication and never do so on your own initiative.
• Prevent panic.
• Look for the most suitable position together with the victim.
• Stay with the victim until normal breathing returns.

Informal caregivers Patients of a patient who is frequently short of breath often receive instructions on the use of a nebulizer/medication delivery system. They can call the GP in case of problems (if this has been agreed). However, if the shortness of breath increases rapidly or the symptoms do not decrease with the previously prescribed medication, immediate action is required: call or have someone call 112.

Hyperventilation

In case of a panic attack and/or rapid breathing (hyperventilation).
A victim may breathe too fast or too deeply. This can lead to shortness of breath or dizziness. A first responder does not need to be able to assess whether the rapid breathing is caused by a panic attack or by oxygen deficiency resulting from, for example, heart failure.

What do you observe?

• Often anxiety or restlessness.
• Shortness of breath or dizziness and palpitations.
• Sometimes stabbing pain in the chest.
• Sometimes tingling in the fingers and around the mouth.
• Cramping of fingers and toes during a prolonged attack.

What are you doing? 

• Call or have someone call 112 in case of chest pain or severe shortness of breath.
• Have the victim sit down and ensure that he does not exert himself.

Let him choose the best posture himself.

• Try to distract the victim during a panic attack.

A real panic attack is harmless, but it is very unpleasant.
Call 112 in case of chest pain or severe shortness of breath/difficulty breathing.

Use the well-known paper bag only if the victim frequently experiences 'rapid breathing' (often for psychological reasons). It is possible that the attending physician has prescribed breathing into a bag. In that case, the victim will often carry such a device and point it out to the emergency responder. In that instance, its use is, of course, permitted.

Diabetes

The greatest danger is that blood sugar levels become (much) too low (hypoglycemia). Initially, low blood sugar will be accompanied by paleness, sweating, fatigue, trembling, and blurred vision. At this stage, eating or drinking something sweet or bread (sugar or a slice of bread with jam) helps. Often, once the victim recognizes the problem, they will do this themselves or ask about it.

A further drop can result in unconsciousness, and 112 must be called. High blood sugar levels (hyperglycemia) can also cause symptoms, but are often less acute.

Checking for a fall in case of impending fainting

Epilepsy

During minor epileptic seizures, the person is often briefly absent, stares blankly ahead, and does not respond to being spoken to. During a major epileptic seizure, the person loses control of their body and suddenly falls to the ground. The entire body jerks and contracts with uncontrolled movements. During such a seizure, the victim is unresponsive. A major epileptic seizure is also called a tonic-clonic seizure.

What do you observe? 

• An arm, leg, or the head suddenly makes uncontrollable shaking movements.
• The victim suddenly loses consciousness and involuntarily tenses his muscles.
• Often has bloody saliva from the mouth and loss of urine.

What are you doing?

• Prevent the victim from getting hurt.
• Protect your head with a small pillow, a towel, or a jacket.
• Do not put anything in the victim's mouth.
• Call or have someone call 112 in the event of a major epileptic seizure or if the victim remains unconscious after the seizure. Put the phone on speakerphone.
• Loosen tight clothing.
• Lay the victim on their side after the attack if the victim is unresponsive.
• Cover the victim with a blanket or coat in cold and/or wet conditions.
• Let the victim rest for a while after the epileptic seizure.
• In the event of a minor epileptic seizure, advise the victim to call the GP.

Informal care
In the context of informal care, and if you know the patient (and their seizures), you may wait for the seizure to run its course or administer medication (midazolam nasal spray). If necessary, contact the general practitioner.

Febrile seizures

Febrile seizures can occur in a child with a fever. Sudden, violent jerks and twitches occur in both arms and legs, and the child may briefly stop breathing. Febrile seizures are most common in children aged six to six years at the onset of an infectious disease. Sometimes, febrile seizures are the first signs of the underlying illness and appear out of nowhere. However, febrile seizures do not always occur with a rapidly rising temperature. 

What do you observe?

• Seizures can occur, especially in babies and children from 6 months to six years of age, with a rapidly rising fever.
• The child makes jerky movements. This may last for several minutes.
• The child may stop breathing for a moment.

What are you doing? 

• Call or have someone call 112.
• Prevent the child from hurting themselves during the shocks.
• Do not put anything in the child's mouth.
• Remove warm blankets or thick coats from the child in case of fever and febrile seizures.
• Ensure that the child can recover in a calm manner (also by remaining as calm as possible yourself).
• Lay the child on their side after the febrile seizure.

Occasionally, there is no fever yet, but the temperature only rises in the hours following the attack. Parents can give the child paracetamol to lower the fever in general (the dosage is stated in the medication's package leaflet).

Bone fractures

A bone fracture is the complete or partial breaking of a bone. If the body shows a wound at the site of the fracture, we speak of an open bone fracture, even if the broken bone is not visible. 

• Severe pain, discoloration and/or swelling.
• The victim cannot move the injured body part normally or bear weight on it.
• Sometimes a visible wound, abnormal position, abnormal mobility, or a cracking sound when moving.

What are you doing?

• Do not move the affected limb unnecessarily. 
• Never straighten the limb again.
• Do not apply ice in the event of a clear bone fracture.
• Ask the victim to remove any jewelry from the injured body part if swelling is expected. Assist him/her with this. 
• Do not give the victim anything to eat or drink.

Continue with: Treating injuries to bones and tendons

Dislocation

A dislocation occurs when two bone ends that meet in a joint shift relative to each other. The joint exhibits a deformed, forced position. In most cases, a dislocation is caused by a blow, a fall, or another accident.

• Severe pain.
• An abnormal position of a joint, arm, or leg.
• The victim cannot move the body part normally.
• Sometimes a visible wound, sometimes discoloration and/or swelling.

What are you doing?

• Do not move the affected limb unnecessarily. 
• Never straighten the limb again.
• Cool for approximately 10 to 20 minutes when painful. Stop cooling when the pain increases. .
• Have the victim keep the affected limb elevated during and after cooling to relieve the pain (a total of 30 minutes).
• Cool the injury with ice or a cold pack. Cooling can provide relief from the symptoms. Wrap the cold pack or ice in a thin tea towel or washcloth to prevent the skin from freezing. If available, use the cover supplied with the cold pack. Some cold pack covers have an elastic band with a Velcro closure. This can be repeated 4-5 times on the first day. Cooling is only effective during the first 24 hours after the injury occurs.

• Ask the victim to remove any jewelry from the injured body part if swelling is expected. Assist him/her with this. 
• Do not give the victim anything to eat or drink.

Continue with: Treating injuries to bones and tendons

What are you doing?

• Do not move the affected limb unnecessarily. 
• Never straighten the limb again.
• Cool for approximately 10 to 20 minutes when painful. Stop cooling when the pain increases. .
• Have the victim keep the affected limb elevated during and after cooling to relieve the pain (a total of 30 minutes).
• Cool the injury with ice or a cold pack. Cooling can provide relief from the symptoms. Wrap the cold pack or ice in a thin tea towel or washcloth to prevent the skin from freezing. If available, use the cover supplied with the cold pack. Some cold pack covers have an elastic band with a Velcro closure. This can be repeated 4-5 times on the first day. Cooling is only effective during the first 24 hours after the injury occurs.

• Ask the victim to remove any jewelry from the injured body part if swelling is expected. Assist him/her with this. 
• Do not give the victim anything to eat or drink.

Continue with: Treating injuries to bones and tendons