Intoxication, overdose concerns and urgent escalation

Urgent substance incidents require a calm, practical response. Reduced consciousness, collapse, breathing problems, repeated vomiting, seizures, chest pain, extreme agitation, severe confusion or rapidly worsening drowsiness can all indicate the child needs immediate medical help. Staff must follow emergency procedures without delay.

Children often understate what they have taken because they fear consequences, and peers may give unreliable information. If staff suspect an overdose or are concerned about serious deterioration, uncertainty should prompt urgent medical assessment rather than a wait-and-see approach.

Red flags that need urgent action

• Breathing difficulty: slow, shallow or laboured breathing is an emergency sign.
• Reduced responsiveness: hard to wake, confused or collapsing.
• Repeated vomiting: especially with drowsiness or risk of aspiration.
• Severe agitation or seizures: sudden major change needs urgent help.
• Unknown substance or mixed use: not knowing what was taken increases risk.

When a child's presentation is worsening, being unsure what they took is a reason to escalate faster.