Intoxicated casualties
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Managing an Intoxicated Casualty
An intoxicated casualty is a person whose physical or mental condition has been affected by alcohol, drugs or other substances. Intoxication can impair judgement, coordination, behaviour and levels of consciousness, increasing the risk of injury, illness and medical complications.
The effects of intoxication can vary greatly depending on:
- The type of substance involved
- The amount taken
- The person’s size, age and health
- Whether multiple substances have been used together
How Intoxication Can Affect the Body
Some people may appear relaxed, confused or disorientated, while others may become distressed, aggressive, unpredictable or emotionally unstable.
In more serious cases, intoxication can affect:
- Breathing
- Consciousness
- Coordination and balance
- The body’s normal protective reflexes
- Heart rate and circulation
Severe intoxication can become life-threatening and may require urgent medical attention.
Prioritising Safety
For first aiders and first responders, the first priority is always scene safety.
Ensure the environment is safe for:
- Yourself
- The casualty
- Anyone nearby
Remember that an intoxicated casualty may:
- Be confused or disorientated
- Struggle to understand instructions
- Behave unpredictably
- Be unable to fully explain what has happened
Approach the casualty calmly, introduce yourself clearly and speak in a reassuring and non-threatening manner.
When To Call Emergency Services
Emergency medical assistance should be requested immediately if the casualty:
- Becomes unresponsive
- Has abnormal or slowed breathing
- Shows signs of overdose
- Has suffered an injury
- Appears seriously unwell
- Has a worsening level of consciousness
If in doubt, always seek professional medical advice.
Assessing an Intoxicated Casualty
Begin your assessment by checking:
- Responsiveness
- Airway
- Breathing
- Circulation
This helps determine how serious the situation may be and whether urgent intervention is required.
Signs and Symptoms of Intoxication
Common signs and symptoms may include:
- Confusion or unusual behaviour
- Slurred speech
- Loss of coordination or unsteady walking
- Nausea or vomiting
- Drowsiness or difficulty staying awake
- Reduced responsiveness
- Agitation or emotional changes
Some casualties may deteriorate quickly, particularly if alcohol or drugs have been mixed with medications or other substances.
Recovery Position and Airway Care
If the casualty becomes unconscious but is still breathing normally, place them into the recovery position.
This helps:
- Keep the airway open
- Reduce the risk of choking
- Allow fluids or vomit to drain safely
Continue to monitor the casualty closely while waiting for professional medical help.
Monitoring the Casualty
Carefully monitor the casualty’s:
- Breathing
- Responsiveness
- Level of consciousness
- Overall condition
Remember that intoxication can sometimes hide other serious medical conditions, including:
- Head injuries
- Hypoglycaemia (low blood sugar)
- Drug overdose
- Stroke
- Severe illness or trauma
The Role of First Aiders
By remaining calm, carrying out a careful assessment and seeking medical assistance when required, first aiders can play an important role in helping to keep an intoxicated casualty safe until further medical care arrives.
Good observation, ongoing monitoring and early intervention can help prevent serious complications and potentially save lives.
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