Medical First Aid Guide


Table 6: TOXIC MENTAL CONFUSION

Exposure to chemicals and solvents, including alcohol and illicit substances, may result in disorientation in time and space. In these circumstances, the casualty will usually develop the signs and symptoms within 15 to 30 minutes of exposure. Sudden cessation of heavy alcohol consumption may also cause toxic mental confusion.

Signs and symptoms Treatment
The casualty confuses the day of the week, the month of the year or where they are at that moment in time
  • There is a risk of loss overboard. The person should be kept under close observation in a locked well lit cabin and given repeated reassurance.
  • After removal of the casualty from the polluted atmosphere, no specific treatment is usually necessary.
Agitation (mental agitation, aggressive and sometimes violent behaviour)
  • If the casualty is difficult to manage, give diazepam 10 mg as rectal solution.1
  • Repeat, if necessary, 10 mg diazepam 30 minutes later if medical advice is not immediately available and SEEK RADIO MEDICAL ADVICE.
Agitation, convulsions
  • Protect the airway from being blocked by the tongue or secretions.
  • Give diazepam 10 mg as rectal solution.1
  • RADIO FOR MEDICAL ADVICE.
Excessive exposure to chemicals may lead to convulsions (fits).
Further advice on treatment of convulsions: see table 5.
Hallucinations (hearing voices and/or seeing terrifying images)
  • If the casualty is difficult to manage, give diazepam 10 mg as rectal solution.1
  • Repeat, if necessary, 10 mg diazepam 30 minutes later if medical advice is not immediately available and SEEK RADIO MEDICAL ADVICE.
  • If there is a history of previous mental illness: SEEK RADIO MEDICAL ADVICE.
Sometimes mental illness may confuse the issue. Schizophrenia often results in hearing voices that are not there.

Table 5: Chemical-induced convulsions (seizures, fits)

Table 7: Eye exposure to chemicals


  1. Note: If administration of diazepam as rectal solution is not possible, give haloperidol 5 mg intramuscularly. Haloperidol (e.g. HALDOL™) may be available in the ship’s ordinary medicine chest.