(inhaling through the nose directly over an open
container), “bagging” (holding an open bag or
container over the head), or “huffing” (pouring or
spraying material on a cloth that is held over the mouth
and inhaling through the mouth).
These methods
usually use a bag or other container to concentrate and
retain the propellant thereby producing a quick “high”
for the abuser.
Persons who regularly abuse inhalants risk
permanent and severe brain damage and even sudden
death. The vapors from these volatile chemicals can
react with the fatty tissues in the brain and literally
dissolve them. Additionally, inhalants can reduce the
availability and use of oxygen. Acute and chronic
damage may also occur to the heart, kidneys, liver,
peripheral nervous system, bone marrow, and other
organs. Sudden death can occur from respiratory arrest
or irregular heart rhythms that are often difficult to
treat even if medical care is quickly available.
Signs and symptoms of inhalant abuse closely
resemble a combination of alcohol and marijuana
intoxication. Acute symptoms are very short-lived and
are completely gone within two hours.
Physical
symptoms of withdrawal from inhalants include
hallucinations, nausea, excessive sweating, hand
tremors, muscle cramps, headaches, chills and
d e l i r i u m t r e m e n s .
T h i r t y t o f o r t y d a y s o f
detoxification is required, and relapse is frequent.
HANDLING DRUG-INTOXICATED
PERSONS
As in any emergency medical situation, priorities
of care must be established. Conditions involving
respiratory or cardiac failure must receive immediate
attention before specific action is directed to the drug
abuse symptom. General priorities of care are outlined
below:
The ABCs + D & E: check for adequacy of
airway, breathing, and circulation, signs of
drug/chemical (“D”) induced altered mental
status, and hidden injuries or contact with a
poison revealed by exposing (“E”) parts of the
body covered with clothing or other articles.
Watch for shock! Give appropriate treatment.
If the victim cannot be aroused, place him on his
side so secretions and vomitus can drain from the
mouth and not be aspirated into the lungs.
All adult patients with an altered mental status
should receive dextrose after blood sugar
testing, thiamine, naloxone, and oxygen.
If recommended by the PCC or medical officer,
place the patient on a cardiac monitor and/or
obtain specimens for comprehensive laboratory
work-up (blood and urine).
If recommended by the PCC or medical officer,
decontaminate the gut. (This decontamination
should be accomplished ONLY if the victim is
conscious and the drug was RECENTLY
TAKEN ORALLY.)
Prevent the victim from self-injury while highly
excited or lacking coordination. Use physical
restraints only if absolutely necessary (i.e., upon
failure of chemical restraints).
Calm and reassure the excited patient by “talking
them down” in a quiet, relaxed, and sympathetic
manner.
Gather materials and information to assist in
identifying and treating the suspected drug
problem.
Spoons, paper sacks, eyedroppers,
hypodermic needles, and vials are excellent
identification clues.
The presence of capsules, pills, drug containers,
needle marks (tracks) on the patient’s body, or
paint or other substance around the mouth and
nose, are also important findings of substance
abuse.
A personal history of drug use from the patient or
those accompanying the patient is very
important and may reveal how long the victim
has been abusing drugs, approximate amounts
taken, and time between doses. Knowledge of
past medical problems, including history of
convulsions (with or without drugs) is also
important.
Transport the patient and the materials collected
to a medical treatment facility.
Inform MTF personnel and present the materials
collected at the scene upon arrival at the facility.
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