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When people hear the word overdose," they often think of someone addicted to heroin, crack cocaine or methamphetamine. Unfortunately, substance abuse is an affliction for all walks of life, and these are only a few of many substances that can cause concern for safety professionals.
This article is the product of my personal experience with a worker overdosing on a construction site that I was supervising for a general contractor.
In October 2019, a general laborer collapsed while taking a coffee break. His coworkers and friends attempted to elicit a response, but only heard brief choking and harsh inhalation sounds [sometimes called the death rattle in overdose victims; Harm Reduction Coalition, n.d.(b)]. The crew acted fast: The foreman called 9-1-1, one person called the general contractor, another called for the automated external defibrillator (AED) and cardiopulmonary resuscitation (CPR) was administered fairly quickly at the direction of the emergency dispatcher. The foreman began compressions but when the project superintendent and I arrived at the scene, I took over CPR so the foreman could focus on providing direction to the dispatcher.
As CPR was being performed, the superintendent and I did our best to describe the symptoms for the foreman to relay to dispatch: pinpoint pupils, blue coloration in the skin and lips, unresponsive to outside stimuli, periodic harsh inhalations, and very weak heartbeat, or bradycardia. CPR was given for more than 10 minutes before the fire department arrived and began reading the workers vital signs. After a brief assessment and understanding the symptoms better than we did, the responders administered intravenous naloxone, which revived the worker. The worker was then transported to the emergency room and treated.
There is an important immediate takeaway to interject: During the event, the on-site nurse and I felt the symptoms were indicative of an overdose. We did not administer naloxone ourselves because dispatch insisted that we continue CPR even after we detailed the symptoms. In hindsight, we did not inform dispatch that we had naloxone available. Had we done so, it is reasonable to believe that the emergency dispatchers would have asked us to use it. We agreed that not administering naloxone was a mistake; because the drug would not hurt a person either way, it should be administered if...