Crisis Averted: A Brewer’s Guide to Handling Medical Emergencies
How can you be injured in the brewing industry? Let us count the ways…. No, let’s not. Hopefully, your brewery has accounted for the obvious safety risks like CO2 inhalation, burns, chemical spills, eye wash, basic first aid, etc. However, the threat of a non-job-related medical emergency is real and lurks in the background.
How would you recognize your coworker or customer having a stroke? A heart attack? An overdose? And what would you do? Call 911 of course, but response times can be long. In the meantime, you should be able to provide lifesaving care. You may have the opportunity to save a life from a cardiac emergency, stroke, or overdose.
Your business should have a plan, and your employees need training to know what to do in a medical emergency. Here are some basics and resources to recognize medical emergencies, and how to be prepared.
CARDIAC EMERGENCIES
Cardiovascular diseases (CVDs) are the leading causes of death worldwide, according to the World Health Organization. Sudden Cardiac Arrest, SCA, is the #3 killer of Americans according to the King County Health Department. There is no victim profile. It can happen to anyone at any time. You can prepare by having access to an AED (Automated External Defibrillator) and by knowing how to give CPR. One contributing factor to CVD is the harmful use of alcohol and the risk to us in the beer industry may be higher than in other occupations.
RECOGNIZING A CARDIAC EMERGENCY
First you must recognize the signs of a heart attack or SCA. The American Heart Association says that you must act fast if you see one or more of the following:
The person is not moving, unresponsive, or unconscious.
The person is not breathing normally (has irregular breaths, gasping or gurgling, or is not breathing at all).
The person appears to be having a seizure or is experiencing convulsion-like activity. Cardiac arrest victims commonly appear to be having convulsions.
If the person received a blunt blow to the chest, this can cause cardiac arrest, a condition called commotio cordis. The person may have the signs of cardiac arrest described above and is treated the same.
AED
The AED (Automated External Defibrillator) is a lifesaving device that requires little training. The portable device checks for an abnormal heart rhythm and can deliver an electric shock to the heart in an attempt to restore a normal rhythm. Brands vary, but they all have clear instructions and give audible directions. The kit should have scissors you can use to cut away clothing and a razor to shave chest hair if needed. You will then attach the sticky pads to the person’s right chest and left side so that the heart is in the path between them.
If you see a cardiac event, you need to act fast!
Call 911
Start chest compressions
Find an AED, and follow the prompts. Do not leave the person for more than 10 seconds to get the AED; compressions are the first line of defense.
You can purchase an AED from medical suppliers ranging from $1200-$3000 each. If you don’t have one, just Google “AED near me” to find the closest one and include it in your Medical Emergency Plan. Be sure to publicly register your AED if you have one!
CPR
As mentioned above, the AED is an amazing tool, but you can still save a life without one by performing CPR (Cardiopulmonary Resuscitation). Again, you need to act fast! Call 911 and start CPR. Everyone on your staff should have CPR training.
You may be surprised at how the CPR protocol has changed over the last 20 years. In 2008 the American Heart Association released a Hands-Only protocol for untrained bystanders. Many fire departments can provide in-person or online training very affordably. For example in Seattle, the Fire Department EMS provides in-person training for just $30 per student! Many online programs and commercial training companies can get your employees certified.
By investing in CPR/AED training you are demonstrating your commitment to the wellness of your employees and your community. Making CPR training available once per year and a requirement for employment could save a life!
STROKE
A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood and oxygen it needs, so brain cells die. Stroke is the number five cause of death and a leading cause of disability in the US according to the American Stroke Association.
RECOGNIZING A STROKE
Here are the F.A.S.T. Warning Signs according to the American Stroke Association :
Use the letters in F.A.S.T. to spot a Stroke
F = Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?
A = Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
S = Speech Difficulty – Is speech slurred?
T = Time to call 911 – Stroke is an emergency. Every minute counts. Call 911 immediately. Note the time when any of the symptoms first appear.
Also watch for sudden:
NUMBNESS or weakness of face, arm, or leg, especially on one side of the body
CONFUSION, trouble speaking or understanding speech
TROUBLE SEEING in one or both eyes
TROUBLE WALKING, dizziness, loss of balance or coordination
SEVERE HEADACHE with no known cause
CALL 911
Strokes are an emergency and every minute counts. Call 911 immediately! Follow these steps recommended by Healthline:
Call emergency services: If you recognize stroke symptoms, contact 911 or your local emergency services or have someone else call for you. Stay as calm as possible while waiting for emergency help.
Get them in a safe position: If you’re caring for someone else having a stroke, make sure they’re in a safe, comfortable position. If possible, position them lying on one side with their head slightly raised and supported in case they vomit.
Check to see if they’re breathing: If they’re not breathing, perform chest compressions or CPR. If they’re having difficulty breathing, loosen any constrictive clothing, such as a tie or scarf.
Check to see if they are bleeding: If they are bleeding from a fall, apply pressure to the wound with clean fabric.
Observe the person carefully for any change in condition: Be prepared to tell the emergency operator about their symptoms and when they started. Be sure to mention if the person fell or hit their head.
Communicate calmly: Talk in a calm, reassuring manner.
Prevent choking: Do not give anything to eat or drink.
OVERDOSE
According to the Centers for Disease Control (CDC), the number of U.S. deaths involving opioids surpassed 80,400 in 2021. That's up from 68,630 in 2020 and nearly 50,000 in 2019. Much of that is from illegal fentanyl. It is unfortunate that we need to be aware of and treat overdoses, but as compassionate humans we need to do what we can.
RECOGNIZING AN OVERDOSE
Recognizing an opioid overdose can save someone’s life. Here are the signs you should look for, according to the CDC:
Unconsciousness or inability to awaken
Slow or shallow breathing or difficulty breathing such as choking sounds or a gurgling/snoring noise from a person who cannot be awakened
Discolored skin (especially in nails or lips)
Small, constricted "pinpoint pupils" that don't react to light
If you think someone has overdosed you should call 911, administer naloxone/Narcan, try to keep the person awake and breathing, turn the person on their side to prevent choking and stay with them until EMS arrives.
NARCAN/NALOXONE
Naloxone, also known as Narcan, is a lifesaving medication that can reverse the effects of opioid overdose. It is available as a nasal spray over the counter in all 50 states. Check with your local health department and/ or search for a Harm Reduction organization for training, resources, and maybe even free Narcan. Nalaxone administered by nasal passage takes several minutes to take effect; don’t give more unless you are directed to do it by the dispatcher or other medical professional.
Adding Narcan to your first aid kit, and training your employees to use it could save a life!
Low and High Blood Sugar Events
Low and high blood sugar (hypoglycemia/hyperglycemia) events can happen to anyone, but diabetes is the primary cause.
Recognizing Hypoglycemia (Low Blood Sugar)
Hypoglycemia occurs when blood sugar (glucose) levels drop too low, typically below 70 mg/dL.This can be tricky in the taproom because hypoglycemia can sometimes be mistaken for intoxication. This confusion arises because the symptoms of hypoglycemia and intoxication (from alcohol or other substances) can overlap significantly.
Symptoms Similar to Intoxication:
Slurred Speech: Both hypoglycemia and intoxication can cause slurred or incoherent speech.
Confusion or Disorientation: Individuals may appear confused, disoriented, or unable to focus.
Unsteady Movements: Hypoglycemia can lead to unsteadiness or difficulty walking, similar to being drunk.
Altered Behavior: People experiencing hypoglycemia might seem irritable, aggressive, or overly emotional, which can be misinterpreted as a result of alcohol or drug use.
Loss of Consciousness: In severe cases, both hypoglycemia and intoxication can lead to fainting or unconsciousness.
Key Differences:
Breath Odor: Intoxication, particularly from alcohol, often comes with a distinct smell on the breath, which is not present in hypoglycemia.
Blood Sugar Levels: Measuring blood glucose levels can quickly distinguish hypoglycemia from intoxication.
Response to Carbohydrates: Administering a source of glucose (like juice or candy) can rapidly improve symptoms in a person with hypoglycemia, which wouldn’t occur if they were intoxicated.
Other Symptoms:
Shaking or trembling
Sweating
Dizziness or light-headedness
Hunger
Irritability or mood changes
Pale skin
Rapid heartbeat
Confusion or difficulty concentrating
Blurred vision
In severe cases: seizures, loss of consciousness, or coma
Causes:
Excessive insulin or diabetes medication
Skipping meals or not eating enough
Intense physical activity without adequate food intake
Alcohol consumption, especially without eating
Management:
Consuming fast-acting carbohydrates (e.g., glucose tablets, juice, candy)
Re-checking blood sugar after 15 minutes and repeating if necessary
Long-term: Adjusting medication, meal planning, or physical activity with medical advice
Recognizing Hyperglycemia (High Blood Sugar)
Hyperglycemia occurs when blood sugar levels are too high, typically above 180 mg/dL after meals or over 130 mg/dL when fasting. Hyperglycemia is usually a less acute condition than hypoglycemia but it can be life threatening in severe cases. Emergency care is necessary if you witness signs of DKA or HHS, such as nausea, vomiting, abdominal pain, rapid breathing, or confusion.
Symptoms:
Increased thirst
Frequent urination
Fatigue or tiredness
Blurred vision
Headaches
Difficulty concentrating
Dry mouth
Unexplained weight loss
Slow-healing cuts or sores
In severe cases: diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS), leading to confusion, shortness of breath, or even coma
Causes:
Insufficient insulin or diabetes medication
Overeating, especially carbohydrate-rich foods
Stress or illness
Sedentary lifestyle
Certain medications
Management:
Adjusting insulin or medication as prescribed
Regular physical activity
Eating a balanced diet, monitoring carbohydrate intake
Regularly checking blood sugar levels
Download Sample Emergency Plan PDF DOC
REFERENCES
https://www.osha.gov/medical-first-aid
https://www.osha.gov/emergency-preparedness
https://cpr.heart.org/en/resources/history-of-cpr
https://www.healthline.com/health/stroke/stroke-first-aid
https://www.cdc.gov/stop-overdose/about/index.html
https://www.ready.gov/sites/default/files/documents/files/EmergencyResponsePlan_Oct2012.pdf
ABOUT THE AUTHOR
I’m Katherine Gooding, a Brewer at Flying Bike Cooperative Brewery in Seattle, Washington, USA. The inspiration for this article came from a friend who died suddenly of a massive heart attack in 2024. His family asked that we honor him by getting CPR training to help save lives. The same month my co-worker had a stroke in the brewery (he is ok!). In response, I organized a CPR/AED training for the brewery and the Seattle Pink Boots Society and wrote this article. I also serve on the MBAA (Master Brewers Association of America) safety committee. I believe that breweries should be safe places to make Beer With Benefits!