🚨 Emergency Action Plan Template

1 CALL 911 IMMEDIATELY

Do NOT delay. Say:

• "I need an ambulance at [ADDRESS]"
• "Person is [UNCONSCIOUS / SEIZING / NOT BREATHING / etc.]"
• BE HONEST: "They took psilocybin mushrooms [X] hours ago"
• Medical providers cannot (and won't) report drug use - they need info to save life

2 Immediate First Aid (While Waiting for EMS)

IF UNCONSCIOUS:

• Check breathing and pulse
• If not breathing: Begin CPR (if trained)
• If breathing: Place in recovery position (on side, head tilted back)
• Stay with person, monitor breathing continuously
• Do NOT give food, water, or anything by mouth

IF SEIZING:

• Clear area around person (remove furniture, sharp objects)
• Place something soft under head (pillow, jacket)
• Turn person on side (prevent choking if vomiting)
• Do NOT restrain or put anything in mouth
• Time the seizure (if >5 minutes, emphasize this to 911)
• After seizure: Stay with person, keep airway clear

IF CHEST PAIN / HEART ISSUES:

• Have person sit/lie down in comfortable position
• Loosen tight clothing
• If person takes heart medication (nitroglycerin): Help them take it
• Monitor pulse and breathing
• If person becomes unconscious: Begin CPR

IF DIFFICULTY BREATHING:

• Help person sit upright (easier to breathe)
• Open windows for fresh air
• If person has asthma inhaler: Help them use it
• Encourage slow, deep breaths
• If breathing stops: Begin rescue breathing/CPR

IF HYPERTHERMIA (Overheating):

• Move to cool environment immediately
• Remove excess clothing
• Apply cool (not ice cold) water to skin
• Fan the person
• If conscious: Small sips of cool water
• Monitor temperature (rectal most accurate)
• If temp >104°F (40°C): Medical emergency (brain damage risk)

IF VIOLENT / AGITATED:

• Safety first: Remove yourself if in danger
• Call 911, request police + ambulance (mental health crisis)
• Remove weapons, sharp objects, anything dangerous from area
• Do NOT physically restrain unless trained & absolutely necessary
• Speak calmly, don't argue or escalate
• Give person space (cornered people escalate)

3 Information to Provide to EMS/ER

• What substance: "Psilocybin mushrooms" (be specific)
• How much: Estimate dose (e.g., "About 3 grams dried")
• When: Time of ingestion (e.g., "3 hours ago")
• Route: "Eaten" (vs smoked, injected, etc.)
• Other substances: Alcohol, cannabis, MDMA, LSD, medications
• Medical history: Heart conditions, seizure disorder, mental health conditions, allergies
• Current medications: Especially SSRIs, MAOIs, lithium, or heart meds
• Timeline: When symptoms started, how they've progressed

🚨 CRITICAL: Honest disclosure saves lives. Medical staff will not report to police. Patient safety is their only concern.

1 Assess Immediate Safety

• Is person a danger to themselves? (Self-harm, suicidal ideation, jumping/running into danger)
• Is person a danger to others? (Aggressive, violent, threatening)
• Are they responsive? (Can you communicate, or completely detached from reality?)

If YES to danger questions OR completely unresponsive: Consider calling 911 or crisis hotline

2 Call Psychedelic Peer Support

3 Crisis De-Escalation Techniques

FOR EXTREME PANIC / TERROR:

• Stay calm yourself: Your energy affects them (slow breathing, calm voice)
• Reassurance mantra: "You are safe. This is temporary. The drug will wear off. You will be okay."
• Reality anchoring: "You took psilocybin [X] hours ago. You're having a strong reaction. This is the drug. It will end."
• Physical grounding: "Feel your feet on the floor. Hold this pillow. Feel my hand (if they want touch)."
• Breathing guidance: "Breathe with me: In 4, hold 4, out 6. Again: In 4, hold 4, out 6." (Repeat until calmer)
• Change environment: Move to different room, go outside (if safe), turn on/off lights, change music

FOR PARANOIA / DELUSIONS:

• Don't argue with delusions: Arguing escalates paranoia
• Acknowledge feelings: "I can see you're scared. Let's keep you safe."
• Redirect attention: "Let's focus on your breathing. Let's go to a different room."
• Remove triggers: If afraid of mirrors, cover them. If scared of people, reduce number in room.
• Offer control: "Would you like lights on or off? Sit or lie down? Music or silence?"
• Reality orientation: "I'm [name], your friend. We're at [location]. You took mushrooms. This will pass."

FOR COMPLETE DISSOCIATION / PSYCHOTIC BREAK:

• Ensure physical safety: Remove hazards, stay with person, prevent wandering into danger
• Gentle vocal contact: Speak softly and consistently even if they don't respond
• Avoid overstimulation: Dim lights, reduce noise, minimize people in room
• Wait it out: Dissociation usually passes as drug wears off (2-6 hours)
• If prolonged (>6 hours) OR violent: Call 911 - may need sedation/hospitalization

FOR SELF-HARM IDEATION:

• Take seriously: Even if drug-induced, suicidal thoughts require immediate attention
• Remove means: Secure medications, sharp objects, weapons, high places
• Constant supervision: Do NOT leave person alone
• Call crisis hotline: 988 or Fireworks (1-888-773-7753)
• If immediate danger: Call 911 - request mental health crisis unit if available
• After crisis passes: Follow up with mental health professional

T Talk Them Through It

• "You're okay, you're safe": Repeat as mantra, calmly and confidently
• "This is the drug, it will pass": Reality reminder that this is temporary
• "You took [substance] at [time]": Specific context anchors them
• "I'm here with you": Reassure they're not alone
• "Difficult feelings are part of the journey": Normalize the experience
• "Let the experience flow": Encourage surrender rather than resistance

R Redirect & Reframe

• Change the setting:
  • Move to different room
  • Go outside (if safe and appropriate)
  • Adjust lighting (dimmer or brighter depending on mood)
  • Change temperature (open window, adjust blankets)
• Change the music:
  • Switch from intense to gentle
  • Or turn off music entirely (silence can help)
  • Try nature sounds, binaural beats, or calming instrumentals
• Change the activity:
  • Lying down → sitting up (or vice versa)
  • Closed eyes → open eyes looking at nature/art
  • Stillness → gentle movement (stretching, walking)
• Reframe the experience:
  • "This discomfort might be showing you something important"
  • "What if you let yourself feel this fully instead of fighting it?"
  • "Difficult trips often lead to the most growth"

I Implement Grounding Techniques

5-4-3-2-1 Sensory Grounding:

• 5 things you can SEE: "Look around. Name 5 things you see. That lamp. That plant. The window..."
• 4 things you can TOUCH: "Feel the floor. Touch the blanket. Hold this pillow. Feel your own hand."
• 3 things you can HEAR: "Listen. What sounds? My voice. The birds outside. The fan."
• 2 things you can SMELL: "Can you smell anything? The fresh air. This lavender oil."
• 1 thing you can TASTE: "Focus on the taste in your mouth. Or take a sip of water."

Breathing Techniques:

• Box Breathing: "Breathe in for 4, hold for 4, out for 4, hold for 4. Again." (Repeat 5-10 cycles)
• 4-7-8 Breathing: "In through nose for 4, hold for 7, out through mouth for 8."
• Belly Breathing: "Hand on belly. Breathe deep so your hand rises. Feel your breath."
• Matched breathing: Breathe with them, gradually slowing your pace (they'll naturally match you)

Physical Grounding:

• Feet on floor: "Feel your feet firmly on the ground. Press down. You're connected to the earth."
• Hold an object: "Hold this crystal/stone/stuffed animal. Feel its weight and texture."
• Cold water: "Put your hands in this cold water. Feel the temperature." (Activates vagus nerve, calms nervous system)
• Gentle pressure: "Squeeze my hand. Feel this weighted blanket. Hug this pillow."

P Provide Comfort & Patience

• Physical comfort:
  • Offer blanket or remove it (temperature regulation)
  • Adjust pillows, help them find comfortable position
  • Offer water (small sips if they want)
  • Dim/brighten lights as needed
• Emotional comfort:
  • "You're allowed to feel however you feel"
  • "There's no wrong way to experience this"
  • "I'm not judging you or your experience"
  • "You're doing great, you're handling this"
• Patience:
  • Don't rush them to "feel better"
  • Let them process at their own pace
  • Sit in silence if they need quiet
  • Repeat reassurances as many times as needed
  • Remember: Peaks pass. This WILL get better in 1-3 hours.