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Paul Dillon speaks to thousands of students across Australia providing information on alcohol and drugs, particularly in relation to looking after
themselves and their friends. Some young people make contact with him to ask questions that they did not feel comfortable asking in front of their peers.
The Real Deal on Drugs allows young people to ask questions about drugs and provides them with access to accurate and up-to-date information.

I'm the one in our group who is always looking after my drunk friends. I'm getting pretty over it but I do feel confident that I'm doing the right thing most of the time. It's when they vomit that I start to panic – I just don't know what to do and worry that if I do the wrong thing something real bad may happen. I don't want the death of a friend on my conscience and even though I know I'm most probably meant to call an ambulance if I'm really worried I'm not too sure my friends would let me. What should I do with a vomiting friend?

If you're going to look after someone who is vomiting, you've got to know why it is happening … When you drink too much, alcohol 'turns off' the brain areas that control consciousness, respiration and heart rate. This can result in unconsciousness, coma and, in extreme cases, death - put simply, you've been poisoned!

Luckily our bodies try to protect us from getting that far by making us vomit and getting rid of unabsorbed alcohol before it reaches the brain. Your brain has specialized poison control cells that detect when you have had too much alcohol and when you reach that point a signal is sent to your stomach to vomit. Essentially the logic is, if you can prevent any alcohol that's still in the stomach from getting being absorbed into the blood stream, it may prevent further poisoning and in the process, save your life.

It is vital that young people understand that vomiting can be life-threatening. Almost every one of the deaths of young women that I have been involved with have involved vomiting, usually choking on their own vomit with their friends right next to them, unaware of what was happening. If someone is vomiting, or looks as though they may start, stick with them – never leave them, not even for a few seconds. It can take just seconds for someone to choke on their own vomit so it is vital you stay with them and monitor them closely at all times.

If they are feeling sick there is every likelihood that they may be feverish. Their temperature may rise and often they will want to take off surplus clothing and footwear. Putting a cold compress (or even a cold water bottle) on the back of the person's neck can make them feel much more comfortable. Make sure that there is also something warm to wrap around them just in case they start to get cold – this is particularly true in situations where young people gather in parks or country areas to drink.

Hydration is a difficult one – too often young people (and adults too) pour water down their friends throat believing that somehow this is going to fix everything. Of course, if they are not being sick, make sure that the person replaces lost fluids, i.e., if they have been urinating or sweating a lot, they need to drink some water. It is also important to make sure that someone rehydrates once they have finished vomiting, but if you give them water to drink while they are vomiting, it is highly likely that they will simply vomit it back up relatively quickly. My advice is to soak a t-shirt or cloth in cold water and then have the person vomiting suck on that in between being sick. That way, they are still rehydrating (but not gulping water down, potentially making them vomit even more) and also making their mouth feel a little more pleasant. As I've said, once they have finished vomiting (and they will know when they have reached that point), they should slowly rehydrate (little sips of water to begin with and building up to more over time) before they consider going to bed and recovering from their unpleasant experience.

Also, never prop a drunk friend onto a toilet bowl to vomit. I have heard too many stories of young people ending up with a range of facial injuries (losing teeth, breaking their noses, etc) when they have been left lying over a toilet and have either passed out or fallen to sleep and smashed their faces onto the porcelain. Take them to a safe place (maybe a well-lit back garden where if they do fall they are less likely to hurt themselves) and give them a plastic bucket - they certainly don't need to throw up in a toilet!

One warning sign to look out for is blood in vomit. This can be caused by something as simple as the person biting the inside of their mouth or tongue but it can also be due to something more serious, such as retching tearing the small blood vessels of the throat or the oesophagus. This usually looks like small red streaks in the vomit, like nose bleed blood. Although this may not be life threatening there is no way of knowing for sure without seeking medical attention.

No matter what happens, if in doubt, don't hesitate to call for medical assistance. It's hard to be too specific here as everyone is so different when it comes to what constitutes a 'medical emergency' but what I usually say is "If it doesn't feel right, it usually isn't!" Even if the ambulance arrives and the situation has resolved itself – it's better to be safe than sorry.

As much as some young people see vomiting as just part of the 'alcohol experience' – a negative part, but a part nevertheless - it can be a life threatening situation. Look after a vomiting person the best you can, never leave them and monitor them closely, but if you for one minute think the situation is getting out of control, call for help immediately!