Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Call your local emergency number now if someone who may have taken hydromorphone:
Cannot be woken
Is not breathing normally
Has long pauses between breaths
Makes choking, snoring, or gurgling sounds while unresponsive
Has blue, gray, or unusually pale lips or skin
Collapses, has a seizure, or becomes suddenly confused
Stay with them until emergency responders arrive.
And for anyone, someone who:
is unconscious, or cannot be woken
you believe has taken an overdose or swallowed something poisonous
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
2
Is any of this happening?
Be seen today
Do not wait to see whether the person improves without treatment.
An accidental extra dose also needs prompt expert advice, even if there are no symptoms yet.
Contact a poison center or urgent medical service right away because dangerous sleepiness and breathing problems may develop later.
In the United States, Poison Help is available at 1-800-222-1222.
3
Does any of this apply?
Book an appointment
For routine follow-up, contact the clinician who prescribes the medicine if hydromorphone is causing persistent sleepiness, dizziness, confusion, or other difficult side effects.
Do not stop regular opioid treatment suddenly without medical guidance, because withdrawal and uncontrolled pain may result.
And for anyone, someone who:
is having side effects from a medicine, or is struggling to take it as prescribed
The article also says
Give naloxone if it is available.
Every sign above is quoted from the sofidex article on Hydromorphone overdose. If you are not sure, err upward — it is always reasonable to be checked.