How should you assess a juvenile who may be intoxicated or have substance exposure?

• A. Give water and food to calm them
• B. Ignore intoxication and proceed
• C. Restrain immediately
• D. Check airway, breathing, pupils, mental status; avoid giving anything by mouth; call EMS if uncertain

Answer: (D)

When a juvenile may be intoxicated or exposed to substances, start with a quick, systematic assessment focused on safety and basic life support. The priority is the airway and breathing because substances can depress respiration or lead to vomiting and aspiration, which can quickly become life-threatening. Check that the airway is clear and that breathing is present and adequate. If there are any signs of trouble—no breath, slow or irregular breathing, or decreasing responsiveness—act immediately, and call for emergency help.

Assess mental status to understand how the central nervous system is affected: orientation, responsiveness, and level of consciousness. This helps you gauge severity and urgency and determines whether you need to monitor closely or escalate care. Checking the pupils provides additional clues about the type and extent of substance exposure, since certain substances produce characteristic pupil changes that reflect CNS involvement.

Avoid giving anything by mouth. With potential intoxication, vomiting or reduced consciousness can lead to choking or aspiration, so oral intake should wait until the patient is fully alert and able to swallow safely. If you’re unsure about the severity or the patient’s stability, call emergency medical services for a professional assessment and potential advanced care.

In summary, prioritize airway and breathing, assess mental status and pupil response to gauge seriousness, avoid oral intake, and seek EMS if there’s any doubt about safety or stability.