First aid for trip sitters and psychedelic therapists

Dirt in the eye

A grain of sand, a speck of dust, or an insect in the eye is very painful and feels burning. Sometimes the foreign object in the eye is visible. Objects lodged on the cornea may only be removed by an ophthalmologist. The victim may remove contact lenses themselves. Because eye injuries are often accompanied by sudden blurred vision or the inability to see at all, the victim may be anxious and in a panic. It is therefore important to reassure the victim. Keep talking to the victim and explain what is going to happen.

What do you observe? 

• There is often fear and restlessness, often narrowed eyelids.
• Pain in one or both eyes.
• Red eye or watery eyes.
• Sometimes: visible speck of dirt.
• Sometimes: reduced vision.

Eye injuries

Eye wash

Execution:

• Prevent the victim from rubbing their eye.
• Have the victim sit somewhere with sufficient light to examine the eye.
• Stand behind the victim. Ask them to tilt their head slightly backward.
• Gently spread both eyelids open with your thumb and index finger.
• Only remove dirt from the eye that is located on the white of the eye.
• Gently rinse the eye with water from a glass or an eye wash bottle.

Tick bite

What do you observe? 

• After a few hours, the bite may start to itch.
• A tick engorged with blood is about the size of a pea.

What are you doing?

• Remove the tick as soon as possible using fine tweezers, preferably pointed tweezers without ridges.
• Grasp the tick as close to the skin as possible. Do not squeeze the body of the tick.
• Make a gentle pulling motion to dislodge the tick and force it to release its grip on the skin.
• Note the date on which you found and removed the tick.
• If they have not yet bitten, ticks can also be removed with adhesive tape or a plaster.
• Disinfect the area with disinfectant only after the tick is gone.

For other instruments, such as tick tweezers, the instructions for use must be followed, including regarding whether to remove it from the skin straight or by twisting. Be certain that it is a tick and not a mole.

Check the tick bite!

A red circle is not always present after infection with the bacteria. Joint complaints, facial paralysis, and cold symptoms are important reasons to contact your GP.

Check the tick bite regularly and contact your GP:

• for itching all over the body;
• if it is not possible to remove a tick;
• if a tick has likely already been attached to the skin for 24 hours;
• if a red, yellowish, or bluish-red spot or ring appears near a tick bite within a few days to three months;
• if flu-like symptoms with fever, headache, muscle pain, and fatigue develop within three months after a tick bite;
• with double vision or a crooked face;
• in case of pain, tingling, or reduced strength in the arm or leg;
• for skin, heart, or joint complaints.

Insect sting

Usually, an insect bite is harmless, causing only brief discomfort due to pain or itching. This is different, however, if a child is allergic or has been bitten multiple times. Always call 112 if the child is known to have a severe allergic reaction after an insect bite. A bite in the throat or mouth can also be life-threatening due to possible swelling and obstruction of the airway.

What do you observe?

• Local swelling, redness, itching, and often pain.

What are you doing?

• Call or have someone call 112 if the child has been stung in the mouth or throat, or in the event of a severe (allergic) reaction.
• Scrape the stinger away with your fingernail or the blunt side of a knife.
• Cool the sting site with a wet compress or a cold pack. If the child has been stung in the mouth, have the child suck on an ice cube to reduce swelling.
• Use an ointment for the skin irritation if necessary.
• Contact your GP if the sting site becomes very swollen.
• Remove ring(s) in case of an insect bite on the finger.

Acute localized itching from an insect bite can be relieved by cooling with cold wet compresses or ice. The anti-itching effect of some creams is also based on cooling (through the evaporation of water or alcohol). For severe itching, ointment or cream containing menthol, Aloe Vera, or calendula can provide relief. 

Oak processionary caterpillar

In certain regions, hairy caterpillars can be found on oak trees in early summer. They are the larvae of a moth. Around the end of April, the caterpillars hatch from the eggs. At that time, they are orange and not yet hairy. After several molts, from mid-May to June, they turn brown and develop stinging hairs on their backs. The caterpillar's stinging hairs penetrate the skin, eyes, and respiratory tract. This leads to irritation and can cause very serious inflammation, which can even result in blindness.

What do you observe?

• Irritation of the skin, eyes, and respiratory tract.
• Someone who frequently comes into contact with the oak processionary caterpillar experiences increasingly severe symptoms with each new contact.

What are you doing?

• Call or have someone call 112 in case of severe allergic reactions.
• Avoid scratching or rubbing.
• Remove clothing containing stinging hairs. Wash the clothing at 60°C.
• Remove stinging hairs from the skin with adhesive tape.
• Rinse the skin or eyes thoroughly with lukewarm water.

For severe itching, ointment or cream with Menthol, Aloe Vera, or Calendula can provide relief.

Jellyfish and sea creatures

When walking on the beach or swimming in the sea, you may come into contact with jellyfish. They carry stinging cells on their bodies that secrete a substance to paralyze their prey. Other cnidarians, such as sea anemones or coral, can also cause irritation to humans.

The weever is a stinging bottom-dwelling fish that hides on the seabed among the sand. Usually, the sting is only painful and bothersome, but sometimes it can even cause shock or infection.

What do you observe?

• In the event of a severe reaction: More severe swelling, redness, itching, and pain, much more widespread over the entire body. Sometimes very ill, with possible 'shock' symptoms.
• Usually: Local swelling, redness, itching, and sometimes some pain.

What are you doing?

• In case of a severe reaction: Call or have someone call 112 and leave the victim lying down.
• First, try to scrape away any stinging cells with the blunt side of a knife or credit card.
• Stings from marine animals (jellyfish and weevers) should preferably be treated by immersion in hot water. As hot as can be tolerated.
• No hot water available: rinse with seawater or use a hot pack or cold pack.

It is important to realize that jellyfish on the Dutch coast are never truly dangerous. Vinegar can be life-saving for tropical jellyfish (inquire locally). Other cnidarians, such as sea anemones or coral, can also cause reactions in humans.

After contact with jellyfish tentacles, you must especially keep away from the stung area. Rubbing with sand or towels worsens the pain. Rubbing causes the stings to be pushed further into the skin and to release any stinging cells that may have remained unreleased.

Nettle

The stinging hairs of the stinging nettle are very painful upon contact. At the tip of the knob of each stinging hair is a small barb that becomes lodged in the skin upon contact. In addition to itching and pain, lighter, itchy bumps appear on the skin, which are called urticaria.

What do you observe?

• Red, swollen, and itchy skin.
• Sometimes, after hours, a numb, tingling sensation (especially after the skin comes into contact with water).

What are you doing?

• Itching and pain largely disappear on their own within one hour.
• Acute localized itching can be relieved by cooling with cold wet compresses or ice.
• For severe itching, ointment or cream containing menthol, Aloe Vera, or Calendula can provide relief. The itch-relieving effect of some creams is also based on cooling (through the evaporation of water or alcohol).

Giant hogweed

Giant hogweed is a plant that blooms between July and September along motorways, railways, and in forests. These are plants that can sometimes reach a height of 3.5 meters.

What do you observe?

• Exposure to the sap of the (giant) hogweed or superficial contact with the plant in combination with sunlight.
• After 24 hours: itchy, red spots or blisters.
• After this, large blisters develop. The blisters resemble severe burns (they only heal after one to two weeks).
• Scars may form and the skin may turn brown.

What are you doing?

• Wash the affected skin immediately with plenty of lukewarm water and soap.
• If the eyes have come into contact, then you must Rinse eyes with plenty of water.
• Avoid exposure to UV light (sunlight and tanning bed light). This prevents the formation of blisters.
• Contact your GP in case of extensive contact with the skin and/or blistering.

Allergic reaction (anaphylaxis)

In such a reaction (also known as severe allergic or anaphylactic shock), the body reacts violently to certain substances. As a result, the blood vessels dilate, causing blood pressure to drop too low. Due to swelling, acute narrowing of the airways can occur within a few minutes.

What do you observe?

• Often feels anxious or restless.
• May have one or more of the following symptoms:
  • Irritation in the mouth and throat.
  • Metallic taste and/or itching in the mouth.
  • Spots, itching, redness, nausea or vomiting.
  • Swelling of the throat, tightness in the chest, shortness of breath, coughing, wheezing.
  • Dizziness, unconsciousness, cardiac arrhythmia.

What are you doing?

• Call 112 in case of severe shortness of breath, signs of (anaphylactic) shock and/or swelling in the neck and throat area, or a combination of dizziness, coughing, chest tightness and hoarseness in relation to food intake, an insect sting or bite, or the administration of medication. Deleted link
• Advise the victim to call the GP in case of persistent vomiting and diarrhea, prolonged itching, skin rash, and swelling.
• Follow the instructions of the professional care provider or informal caregiver.

Sometimes anaphylaxis is confused with other reactions that can have similar symptoms, such as hyperventilation, an anxiety attack, low blood pressure, or low blood sugar. It is very difficult for a first responder to recognize the onset of a severe allergic reaction in a child, and it is often only possible to deduce this from the situation.