First Aid, on Acid

I’m burnt, she’s delusional, no one’s coming to help.

So, you went and fucking burnt yourself, your girlfriend thinks her bestie is plotting her downfall and you are in the middle of the fucking woods, which happen to be a vibrant mirror world of fantastical colors. First aid usually has to take place under inconvenient circumstances, talking your partner out of the existential dread of fearing betrayal from a close friend, whilst your skin is melting off, and not just “because of the drugs” melting off, might be amongst the most inconvenient.

Two tabs deep into a 2nd degree burn isn’t ‘ideal’ by your oh so fussy academic standards, but this is the real world, and you, I and our dumb buddy are all perfectly capable of properly tending to open burn wounds whilst enjoying psychedelic drugs in the great outdoors!

So what kind of burn are we dealing with? There’s three severities to burns, first, second and, eesh, third degree:

Regardless of what the end result of the burn is ie. aftercare, the wound will have to be dealt with in much the same manner initially if it’s anything from a larger 1st degree right through to a 3rd degree.

Whilst empathetically providing the burn victim with right to yell their obscenities of choice to deal with the pain, and also the relief that their loved ones aren’t plotting their demise, we should get the burn victim to a safe spot out of any harsh direct sun where we can clear the wound of any burning fluids, ie. grease, fuel etc. This should be done ideally with hydrogen peroxide except for the eyes which should be flushed with eye drops or clean water, though clean water is okay to use for all other wounds in a pinch, what’s important right now is washing anything foreign from the wounded area. Start with the eyes if any burning fluid etc. made contact with the head, crotch, hands and feet before moving on to the rest of the body. Strip away any clothing, including that bleach dyed Misfits tee your happy unburnt ass was wearing a minute ago, and try to be mindful of fabric melting to skin. The quicker it’s away from the skin, the less damage it can do. Trust me when I say that shame goes out the window very quick when your skin is burning away. Despite that, we absolutely do NOT want to just blindly rip clothing away from somewhere it’s sticking to skin, potentially causing more damage than there already is. We also want to remove any constrictive jewelry, watches etc. as burns can swell and lead to further discomfort.

For severe burns, you may have to cut clothing away from the skin. This is best done by someone not tripping balls on gel tabs, but if such a person cannot be found, find someone that works with their hands and isn’t a moron. If in severe doubt where skin and material differentiate, leave material that is difficult to remove and get to work doing a killer job of sterilizing the surrounding area.

The victim, and it’s starting to become difficult to know if that’s you, me, them or all of us, should now be cleaned and cooled. Cold compresses are ideal for a burn, the heat or feeling of it simply needs to leave the injury before the victim will care to wrap it. This could take anywhere from 15 minutes, half an hour to seemingly the end of time, I mean, how have we not yet addressed how motherfucking brutal the shock you go through is when you have a serious burn? Anything as deep as a second degree burn is liable to cause severe mental impairment, mind fog, woeful mind quests for time travel to five minutes ago, some other really bad thing I forgot, memory and indecision. It may also cause paleness, light headedness/fainting and shallow breathing.

This is why it’s important for the caregiver to take firm control over the situation and decision making process. Yes, bad people are coming to get you, but right now we need to keep the process moving. Attention on the wound, the victim will wish to use anything cold to ease the burn, but obviously, not everything is clean enough or otherwise okay to be touching this sticky, demonic portal into hell. I recommend carrying some kind of Lidocaine based burn relief spray from any drug store on you, it will help cool, hydrate and numb the wound. Oh yeah, word to the wise: open wounds whilst under the affects of (totally safe) mind altering drugs are INSANE to look at. Give any worthwhile EMT, medic or otherwise first aid, medically minded person a few tabs and some good old fashioned gorno books to flick through and they will get lost for hours, finding monstrous fangs and eyes peeking behind every flap of warped skin, picturing blood flowing from every fresh sore like the mouth of some hellish river. If you’re a sick fuck, or just a creative that enjoys playing with their sanity just a little for funsies, give that one a go! Once you’ve had a refreshing bout of lunacy, and by that I mean cursing everything within spitting distance, we need to get to hydrating the wound.

Once the wound has been adequately cooled, smoke some sativa because we all fucking need it at this point, and then get to hydrating it. Beggars can’t be choosers, Aloe-based after sun works in a pinch to help cool and hydrate the area but there’s plenty of preferable after burn ointments that will work wonders creating an ideal healing environment for the burn. Around this stage, the victim may notice strange… well strange everything, but potentially they may experience seemingly random pains as your pain center fills every inbox it has on file with 5,000 word emails of ‘Fuck me! It shouldn’t be peeling like that! ‘. This may be a sign of nerve damage or shock, shock can be helped by getting the victim something to eat with some sugar in it, helping them sit down, frequently urging them to “Chill the fuck out,” and helping them drink water. Once after burn ointment or some form of hydration agent has been applied, we can cover the wound.

Now that we’ve had a minute to assess the burn, this should be the point of your first aid decision making process where we need to decide if the patient needs to go to to urgent care and/or seek further medical assistance or if they are good to simply rest and let it heal on its own. Reality check: Anything less than a 3rd degree burn and there’s nothing anyone in the ER will do for you that you can’t do quicker and cheaper with either a well stoked medical kit, IFAK or run to the local drug store unless you’re after some opiates, but I’m more of an ‘edibles and recreational bitching’ kinda guy for pain relief.

Once the wound is moisturized, the sterile (clean hands, just ripped from the packaging, no Cheeto dust and dirt, etc.) gauze pads you hopefully have to hand are best to place over the most seriously damaged areas as these will likely be leaking fluids. Yeah, these things get real nasty and real weird, but that’s life so just relax, will you? The pads should be a barrier between open wound areas with some gauze bandages or something similar to act as a covering to keep the pads and affected area as clean as possible, especially when outdoors. With gauze pads on any wounds, we should now loosely wrap gauze bandages or similar materials that can be fastened tight enough to secure the pads, but loose enough so as to not irritate the afflicted areas with rubbing etc. Keeping safety pins to hand is how I usually secure these as they’re more dependable than common fragile bandage clips.

These coverings will need to be changed every 4-6 hours or whenever your nasty fucking fluids have leaked through. Something to be aware of is the rapid bubbling of skin in affected areas, mostly with a 2nd degree burn or worse. This is perfectly natural, but feel free to freak out anyway. The liquid will build in surprising volumes beneath a thin layer of skin, you may see bubbles through the skin and the buildup to be yellow-ish in color. Having a fleshy fish bowl attached to your body isn’t very useful, but not popping these is absolutely essential to a good healing process without scarring and fluid-filled blisters protect against infection. That’s the ideal scenario anyway, the reality of the situation may be that you have to get back to civilization on foot. In that case, it may be all but impossible to avoid popping a blister if it’s on a foot or leg. In this scenario, we’re going to have to adopt the mindset that ‘Chicks dig scars’ and pop that fucker so we can do so with a sterilized object and clean and dress it on our terms instead of dumping a puddle of human juice down yourself, mid ruck. Again, nasty as hell, but decisions have to be made based on your situation.

The funny thing about people is, we’re all in our heads for the most part. Once someone is in shock and realizes how much damage has been done to their body, the pain they’re in is that much more palpable and is exacerbated by shock and panic. Not only is cleaning and properly dressing a wound ASAP a good idea from a physical standpoint, but ignorance truly is bliss when it comes to the victim’s pain management. Once you wrap the wound and get them back to some semblance of functional, even if that involves a limp or being down to one hand, they can start that healing process from a mental standpoint too. Your trip doesn’t have to be ruined due to an injury and it doesn’t hurt to do drugs with someone medically inclined. What could be the gateway to a nightmare bad trip can be saved with a little common sense and turned into little more than a psychedelic speed bump. After all, drugs are expensive, you should get the most out of them!

If you’ve still got a few hours of your trip left, spend it somewhere you can be a little less mobile, a scenic view, a nice creek, your base camp or otherwise. Have the security of nearby transport and more dressings and cleaning supplies should you need them. Last but certainly not least, a trip guide/sitter can make a world of difference and should be considered absolutely essential for those without much experience on psychedelics. A trip guide is usually someone with experience using said drugs, but not necessarily, that stays sober and looks after those tripping. This can include being a designated driver, steering the experience in a good direction and generally looking out for the wellbeing of those under the influence. A+ if they know the basics of first aid, though this will only be needed if they negligently allow people to play with fire/knives/cliffs etc. while off their ass hallucinating.

On a final note, while this article was inspired by a true story, I did not injure myself while on LSD and I wanted to make that clear for all of the recovering D.A.R.E. educated readers (that’s right, the organization still exists, crazy right?). My girlfriend and I did however, have to change my dressings mid-trip which took five times as long as it would normally as we got distracted looking at them and it spiraled her into a bit of a dark place. That was fixed with a group chat and a smoke as we were coming down which allowed me to enjoy some glitch-like visuals as the evening darkened. All you can do is plan for the best when you’re tripping and set yourself up for success to avoid going down not so enjoyable rabbit holes. In addition to that, first aid skills should not intimidate the everyman. If you can maintain any kind of machine, system or tool, you can learn the various processes to treat different injuries in the field or otherwise out and about. The human body is a system too and inebriated or not, you can look after it in a moment of crisis with the right tools, mindset and muscle memory.

Happy tripping and stay safe my friends!