From: Nurse Charles <hello@nursecharles.com>
To: You

What actually happens in the 4 minutes before help arrives

Most people, when they witness a drug emergency for the first time, freeze.

Not out of indifference. Not out of cowardice. They freeze because the situation is outside anything they have experienced, and the human brain defaults to stillness when it does not have a script for what to do next.

What I want to talk about today is the window that exists while the freeze is happening.


4
Minutes. That's the window. Average EMS response time is 7 to 8 minutes. In a respiratory emergency, brain damage can begin in 4 minutes. The person in the room when it starts is the first responder.

1 in 3 Americans personally knows someone affected by the opioid crisis. That number does not include the people who know someone affected by cannabis toxicity, or a polysubstance emergency, or any other drug-related situation. The number of families who are statistically likely to be in this room is not small.

The freeze response is understandable. It is also the thing that costs people the most in those four minutes.


Three things break the freeze. Not training. Not medical background. These three things:

  1. Knowing what you're looking at. Fewer than 8 breaths per minute. Pinpoint pupils in a person who cannot be woken. Gurgling sounds from an unconscious person. These are the signs. Knowing them means you move instead of wondering.
  2. Having one physical action to take. Recovery position: on their side, airway open. One thing. You can practice it before you need it. When you have a practiced physical response, the freeze breaks faster.
  3. Having Narcan available. Not because you are certain opioids are involved. Because it takes the uncertainty off the table. If opioids are present, it works. If they are not, it does nothing. That certainty is what enables action.

None of this requires a clinical background. It requires knowing it before the moment arrives.


The free Overdose Response Guide walks through all three. Sign recognition, recovery position, Narcan step-by-step, and what to tell 911. It was built for the person standing in a living room, not a treatment room.

More next week. Stay close.

Nurse Charles
RN, 30 Years Emergency Room
Emory Healthcare