Treating Gunshot Wounds: A Professional Responder’s Guide

Treating Gunshot Wounds: A Professional Responder’s Guide

Gunshot wounds are life-threatening emergencies that require quick, precise action. This guide for professional responders covers wound assessment, bleeding control, chest seal application for thoracic injuries, and key steps for safe transport to trauma centers.

Read More

Managing Intoxicated Patients in the Field: An EMR Guide

As an Emergency Medical Responder (EMR), you’re trained to provide care in unpredictable situations. One of the more challenging scenarios is responding to patients under the influence of alcohol or drugs. Intoxicated patients can present with unpredictable behavior, altered physiology, and a higher risk of injury—making careful assessment and management critical.

At Delta Emergency Support Training, we emphasize both safety and effective patient care. Here’s a detailed guide for EMRs on safely responding to intoxicated patients, aligned with Alberta Health Services (AHS) guidelines.

Understanding Intoxication

Intoxication can result from alcohol, prescription medications, or illicit drugs. Common effects include:

  • Altered level of consciousness

  • Slurred speech or impaired coordination

  • Agitation, aggression, or unpredictable behavior

  • Nausea, vomiting, or respiratory depression

  • Increased risk of trauma from falls, fights, or accidents

  • Masked pain: Alcohol can dull pain perception, making trauma patients unreliable reporters of injury severity

  • Mimics: Hyperglycemia or hypoglycemia can appear similar to intoxication, making blood glucose assessment crucial

Recognizing the signs early helps EMRs anticipate complications and prioritize patient and responder safety.

Safety First: Protecting Yourself and Others

Intoxicated patients can be unpredictable. Before providing care, ensure:

  • Scene safety: Survey for weapons, hazards, or bystanders that may interfere.

  • Backup: If the patient is aggressive, call law enforcement or additional responders.

  • Personal protective equipment (PPE): Gloves, eye protection, and masks may be necessary.

  • Distance and positioning: Maintain a safe stance and keep an exit route clear.

Never compromise your safety—intoxicated patients may act impulsively, and an aggressive patient can escalate quickly.

Patient Assessment

Assessment of an intoxicated patient may be complicated by their altered state. EMRs should focus on:

  1. Responsiveness: Determine if the patient is fully conscious, verbally responsive, physically responsive, or unresponsive.

  2. Airway, Breathing, Circulation (ABCs): Alcohol and drugs can depress breathing and circulation.

    • Be prepared to clear the airway using suction if the patient vomits.

    • Airway adjuncts (oropharyngeal or nasopharyngeal airway) may be required if the patient’s airway is compromised but spontaneous breathing is present.

  3. Vital signs: Monitor heart rate, blood pressure, respiratory rate, oxygen saturation, and blood glucose.

    • Hyperglycemia or hypoglycemia can mimic intoxication and significantly affect patient management.

  4. Secondary survey: Look for trauma, especially since alcohol can mask pain. A patient may not report broken bones, internal injuries, or head trauma. Monitor carefully for subtle signs.

Common Challenges and How to Manage Them

  • Aggression or agitation: Stay calm, use a non-confrontational tone, and avoid physical confrontation unless absolutely necessary.

  • Vomiting or aspiration risk: Use suction immediately if needed, and position the patient in the recovery positionif unconscious but breathing.

  • Altered decision-making: Intoxicated patients may refuse care. Document refusals and use implied consent in life-threatening situations.

  • Polysubstance use: Patients may have multiple substances in their system, complicating presentation. Monitor closely for unexpected symptoms.

  • Trauma considerations: Be extra vigilant for head injuries, internal bleeding, or fractures. Pain may be unreliable, so rely on vital signs, visual assessment, and mechanism of injury.

  • Glucose considerations: Rapidly check blood glucose in any altered patient; treating hypoglycemia or hyperglycemia may resolve the presentation entirely.

Communication Tips

  • Use simple, clear language.

  • Speak slowly and calmly to reduce confusion.

  • Avoid judgmental language—patients respond better when treated respectfully.

  • Keep bystanders informed, but focus on patient care.

Transport Considerations

  • Monitor continuously: Intoxicated patients can deteriorate rapidly.

  • Secure safely: If aggressive, use restraints only per local protocols and monitor the patient closely.

  • Communicate with receiving facility: Provide details on level of intoxication, suspected substances, vital signs, airway interventions (suction or adjuncts used), trauma concerns, and any interventions performed.

Red Flags: When to Call for Immediate Backup

  • Unresponsiveness or decreased level of consciousness

  • Difficulty breathing or abnormal airway sounds

  • Vomiting with risk of aspiration

  • Seizures or convulsions

  • Severe trauma, especially head or internal injuries

  • Aggressive or violent behavior that cannot be safely managed

  • Hypoglycemia or hyperglycemia causing altered mental status

Final Thoughts

Responding to intoxicated patients requires a balance of emergency care skills, safety awareness, and empathy. Alcohol or drug use can mask pain and complicate assessment, and abnormal blood glucose levels can mimic intoxication. With proper airway management, suction, airway adjuncts, and glucose monitoring, EMRs can provide effective care safely.

At Delta Emergency Support Training, our courses prepare responders to handle complex patient scenarios, including intoxicated and trauma patients so you can provide care with confidence, skill, and safety.

Distracting Injuries: Pulling Focus and Masking Pain

Distracting Injuries: Pulling Focus and Masking Pain

In trauma care, some injuries grab all the attention—but they aren’t always the deadliest. Distracting injuries can mislead responders and mask life-threatening conditions. Here’s what every first responder needs to know about spotting them, staying systematic, and keeping patient safety the top priority.

Read More

International Trauma Life Support: A Structural Approach to Trauma

International Trauma Life Support: A Structural Approach to Trauma

Need to take ITLS but not sure what it entails? We’ll break it down for you. International Trauma Life Support (ITLS) gives professional responders the tools to quickly assess, stabilize, and manage trauma patients in high-stress situations. From airway management to bleeding control and spinal care, this course equips you with practical, hands-on skills that could save lives when every second counts.

Read More

How EMRs Can Succeed in Remote and Isolated Worksites

How EMRs Can Succeed in Remote and Isolated Worksites

Working as an Emergency Medical Responder (EMR) on a remote worksite means being ready for anything—from minor injuries to life-threatening emergencies—often with limited resources and no backup nearby. Whether you’re on an oilfield, logging site, or rural road, you may be the only trained responder for hours. Success depends on preparation, strong communication, and the ability to improvise. By mastering these skills, EMRs ensure that patients receive the best possible care until advanced help arrives.

Read More

How to Prevent Spinal Injuries: Essential Steps for Safety

How to Prevent Spinal Injuries: Essential Steps for Safety

Spinal injuries can have devastating consequences, from paralysis to lifelong medical complications. Fortunately, many of these injuries are preventable. In this blog, we explore the top causes of spinal injuries, shocking statistics, and expert-approved safety measures to help you stay protected. Whether it’s safe driving, fall prevention, or sports safety, taking proactive steps can make all the difference. Plus, learn how Delta Emergency Support Training, a Red Cross Training Partner, provides essential first aid training to equip you with life-saving skills.

Read More

How to Handle Eviscerations in Trauma: A Guide for EMRs and AFA Responders

How to Handle Eviscerations in Trauma: A Guide for EMRs and AFA Responders

Evisceration is a serious, life-threatening injury where internal organs protrude through an abdominal wound. As an EMR or AFA responder, it's crucial to provide immediate care by controlling bleeding, protecting exposed organs, and stabilizing the patient for transport. This blog outlines key steps and considerations to manage eviscerations effectively.

Read More

EMR Guide to Facial Trauma: Airway Management, Bleeding Control, and Injury Assessment

EMR Guide to Facial Trauma: Airway Management, Bleeding Control, and Injury Assessment

Facial trauma is a serious medical emergency that requires prompt attention. This guide for EMRs covers essential steps for managing facial injuries, including airway management, bleeding control, and fracture stabilization. Learn how to assess and treat patients with maxillofacial trauma to reduce the risk of permanent functional loss and disfigurement.

Read More

Ejections from Vehicles: What Every First Responder Should Know

Ejections from Vehicles: What Every First Responder Should Know

Vehicle ejections are one of the most dangerous and traumatic incidents first responders encounter. This blog provides vital insights into the causes, injuries, and best practices for responding to ejections, as well as how advanced first aid training can help firefighters and emergency responders handle these high-risk situations effectively.

Read More

Skin Anatomy Overview for First Responders: Layers and Functions

Skin Anatomy Overview for First Responders: Layers and Functions

Understanding the anatomy of the skin is essential for first responders. The skin serves as the body’s first line of defense, regulating temperature and protecting against infection. In this blog, we’ll break down the three layers of skin—epidermis, dermis, and hypodermis—and explore their functions, common injuries, and how this knowledge can help you provide better care in emergency situations.

Read More

Navigating the Complexity of Broken Pelvis: Causes, Symptoms, and Care

Navigating the Complexity of Broken Pelvis: Causes, Symptoms, and Care

In our comprehensive guide, we unveil the intricacies of pelvic fractures, shedding light on their causes, recognizing vital symptoms, and offering essential tips for immediate care. Unlock the secrets of this often-underestimated injury and empower yourself to make a difference in emergencies.

Read More

Unraveling Traumatic Brain Injuries: Causes, Effects, and Signs

Unraveling Traumatic Brain Injuries: Causes, Effects, and Signs

Unravel the complex terrain of traumatic brain injuries, where the immediate impact is just the beginning. Explore the hidden consequences as we delve into the intricate aftermath of these injuries. From internal bleeding that disrupts brain function to bruised brain tissue and the delicate damage to nerve cells, discover how hemorrhaging, contusions, and axonal injury cast a far-reaching impact. Our exploration not only sheds light on the physiological intricacies but also emphasizes the critical need for comprehensive care and healing strategies. Join us in uncovering the hidden layers of traumatic brain injuries and understanding their profound implications on both the brain and the individual's well-being.

Read More