Table 2 Participants’ reported responses to managing diverse symptoms associated with stages of GHB overdose, and first aid recommended actions
From: Understandings, attitudes, practices and responses to GHB overdose among GHB consumers
Participants report | First aid recommended actions | ||
|---|---|---|---|
Stage | Response | Actions taken by bystanders | |
Initial symptoms of distress | Preparing for safety | Checking in, e.g., asking if ok. Providing water to sip. Moving to a quiet environment with less stimulus | Assess for dangers, remove hazards and mitigate risks associated with falling Check on other medical conditions Ask what substances have been taken and when Ask for emergency contact information if a deterioration occurs and hospital attendance is required |
Urge to sleep or near loss of lucidity | Dosing stimulants | Dosing stimulants such as cocaine or crystal methamphetamine (perceived to help retain alertness responsiveness) | Increases intoxication, may cause stimulant toxicity, stimulants not an antidote to GHB overdose.* |
Providing citrus | Providing someone with a drink of orange juice Putting a lemon or lime wedge in mouth | No evidence | |
Keeping someone alert | Standing under a shower Biting nipple Rubbing sternum Shouting Shaking, slapping & hitting Splashing Punching throat | First aid principles promote checking responsiveness by squeezing shoulder or speaking loudly.** Call emergency medical services if someone is not responsive.** Biting, shaking, slapping, hitting, standing someone upright, forcing someone into a shower or punching may risk accident and injury | |
GHB-induced sleep (responsive and non-responsive) | Checking for responsiveness | Waking someone with pain or sound stimulus Asking someone to say their name Asking someone to squeeze hand | First aid principles promote checking responsiveness by squeezing shoulder or speaking loudly.** |
Observing | Sitting with someone for a duration of hours Placing someone in the next room and intermittently monitoring | Call emergency medical services if someone is not responsive and do not leave someone who is non-responsive unmonitored.** | |
Assessing breathing | Monitoring for unusual breathing sounds, patterns, or faint breathing | Call emergency medical services if someone is not responsive, look listen and feel for normal breathing.** If non-responsive and not normal breathing, then first aid recommendations are to call EMS and start CPR** | |
Managing airways | Putting into the recovery position | Call emergency medical services if someone is not responsive, assess breathing and place in the recovery position.** To manage airway open mouth and check for foreign material. If foreign material is present roll the patient onto their side and clear the airway. If there is no foreign material, leave the patient in the position found, and open the airway by tilting the head back with a chin lift | |
Ensuring comfort | Putting someone in a spare bedroom or safer location Ensuring body has not contorted into a potentially injurious position | Call emergency medical services if someone is not responsive, assess breathing and place in the recovery position. Remove environmental hazards and do not leave the person unmonitored** | |
Collaboration | Lifting the deadweight of a body to a separate location, Discussing decision to call or not call for ambulance | Call emergency medical services if someone is not responsive. Only move non-responsive person if they are in immediate danger Assess breathing and place in the recovery position.** | |
Getting help | Driving someone to hospital Calling an ambulance / emergency medical services Getting a ride-share to hospital | Call emergency medical services if someone is not responsive.** | |