in the event of an overdose, in an emergency setting, the priority is always on airway, breathing, and circulation, in that order. if the ragepig is apneic (not breathing), bradypnic (breathing too slowly or too shallowly), or hypoxic (has low blood oxygen saturation), he'll be rolled onto his back, an adjunct will be placed in his mouth to keep his fat tongue out of the way, and ems will attempt to ventilate him with a bag-valve mask connected to an oxygen supply. this will be complicated, because he's so fat around his shoulders and neck that it will be difficult to position his head to effectively ventilate him, and his face is so fat and hairy that it will be difficult to form a proper seal with the bvm.
he'll also likely vomit due to a combination of the alcohol, the drugs, and the inadvertent introduction of oxygen into his stomach from improper bagging, in which case, ventilation will be stopped while he's rolled onto his side, the adjunct is removed, and his mouth is suctioned. this will be the indication to ems that his airway needs to be protected with intubation. one person will continue to try to manually ventilate him with the bvm, while another person will gather the necessary equipment.
if he's still somewhat conscious and resists, the only way to intubate is with a technique called rapid sequence intubation (RSI), in which an i.v. is placed (which will be difficult because he's so fat with such horrible skin), and a hypnotic, then a paralytic, is administered prior to intubation. i don't even know if they do this in mexico.
regardless, ems will attempt to pre-oxygenate him with the bvm, then a laryngoscope will be placed in his mouth and down his throat. again, this will be difficult because he's so fat, and even moreso if there's any vomit in his throat that they weren't able suction. if his vocal cords are able to be visualized, an endotracheal tube will be inserted, the bladder that holds it in place in his trachea will be inflated, and they'll attempt to ventilate while watching for chest rise and listening for the sounds of lung expansion with a stethoscope.
if they're successful, they'll secure the tube by strapping it to his face, and they'll continue to manually ventilate with the bag connected directly to the tube, rather than to the mask. if they're not successful, they'll pull the tube, insert an adjunct, attempt to manually ventilate for a bit while suctioning as needed, and then they'll try to intubate again. if they don't succeed after a couple of attempts, they'll just load and go.
remember, this whole time, he may not actually be receiving proper ventilation, and he's nowhere near definitive medical care. they still have to get him out of wherever he is, into an ambulance, and to the nearest hospital. it only takes six minutes without oxygen for irreversible brain damage to occur (although, this is the ragepig, so there's not much to lose). whether he's intubated or not, one person will have to continue to manually ventilate, suction, and monitor his vital signs, while the other person contacts the hospital and drives the ambulance. unless they have to r.s.i., they will not be worried about administering anything besides oxygen.
if he survives at all, he'll likely have (more) brain damage, a nasty infection from aspirating vomit, as well as some damage to his trachea and larynx. all of which will have to be treated by mexican healthcare providers, in a mexican hospital, without any insurance, without any money, and without the means by which to plead with his paypigs for assistance, while his wife and daughter wait for him to recover. it's fucking grim.
edited: i forgot to mention that if he's in the hospital for more than a day or so, he'll also experience withdrawal from both the alcohol and the benzodiazepines, either of which, as mentioned by others, is life-threatening. his withdrawal will be managed medically, but i can't imagine that it'll be a pleasant experience for an american ragepig who just overdosed while living in mexico with an expired visa and no health insurance.
source: former paramedic, although, not in mexico
