Unconsciousness

An individual, who is unresponsive to speech, touch or pain stimuli despite normal breathing and circulation, is unconscious. The casualty lacks consciousness, muscle tension and vital defense reflexes. A person in this condition is helpless and defenseless.

Causes:

Head and brain injuries:

• Concussion
• Contusion
• Cerebral pressure caused by swelling of the brain and cerebral bleeding.

Poisoning:

• By toxic gases
• By poisons

Other causes:

• Sunstroke, heatstroke
• Stroke
• Brain diseases (epilepsy, meningitis, etc.)
• Metabolic diseases (diabetes, etc.)

Assessment:

Check consciousness:

• Talk to the motionless casualty
• Rouse the casualty by tapping
• Apply light pain stimuli

If the casualty does not respond adequately, he is without consciousness:

Call for help (Help! Can somebody help me?) then

Check breathing

Clear the airway (upper respiratory tract):

• Loosen tight clothing and remove strangling objects.
• Inspect the oral cavity: it vomit, blood, mucus, broken, or dislocated dentures are to be removed from the oral cavity, turn the casualty’s head to the side (use disposable gloves or a fabric handkerchief).
• Tilt the casualty’s head backwards keeping his neck arched and lift his tongue it has fallen back, thus enabling unobstructed breathing: then

Check breathing i.e. listen for the casualty’s breath. Watch his chest and your ear close to the casualty’s mouth to feel the breaths. Continuous to check the casualty’s breathing for about 10 seconds. If you feel and hear the casualty breathe, and see his chest move, his breathing is intact: then,

Check circulation:

Feel the carotid pulse:

Gently pull the casualty’s head backwards and with several fingertips feel for the neck artery pulse for 5-10 second on each side). If the carotid pulse can be felt, circulation is still functioning.

If the casualty is without consciousness, but breathing and circulation are apparent, there is the emergency case of unconsciousness.

Danger

Any unconscious casualty is in danger of dying while lying face upwards, as the airway might be blocked by foreign matter, vomit or curled-back tongue, which could cause death by suffocation.

First Aid

Keep the breathing passage clear by turning the casualty into a stable lateral position, the so-called “recovery position”.

Realization:

1. Place the arm nearest to you by the casualty’s side.
2. Take the opposite arm at the wrist and the far leg at the hollow of the knee; bend the knee so that arm and leg form a stable triangle with the body.
3. Turn the casualty gently to a lateral position.
4. Tilt the casualty’s head back and turn the face towards the ground to prevent the tongue from blocking the airway and to make blood, secretions or vomit drain off from the mouth.

Important Point:

• Check breathing and circulation in one minute intervals.
• Emergency call
• Further shock treatment