Unconsciousness occurs when the oxygen supply to the brain becomes inadequate. There is not enough oxygen for the nervous system to control normal activities. So there may be a slow or gradual dulling of senses, often precipitated by a slowing of movements, general vagueness and finally dizziness, maybe drowsiness and finally a total lack of consciousness. Often this may be simple, due to fainting, where a momentary lack of oxygen occurs, and recovery is usually quick. However, there may be other serious underlying causes present as well. The patient may be a diabetic suffering from excessively high sugar levels (diabetic coma) that require urgent treatment to prevent death. Or there may be too much insulin as a result of treatment undertaken when the patient may have missed meals or over exercised, or some other condition.
Epilepsy is a well-known cause of unconsciousness, and the patient may have a series of convulsions prior to lapsing into the unconscious state. The situation may have occurred as a result of accident, in which case there is usually some other indication at the same time. It may have been due to trauma to the brain.
Many drugs and poisons may produce unconsciousness, and this includes alcoholic excesses. There may be evidence of these about the patient. A heart attack may have occurred, or the patient may have been electrocuted, in which case there is usually some obvious evidence.
When first confronted with an unconscious patient, they will have little knowledge of what has taken place. Therefore, a quick, preliminary assessment is essential.
After this, attention to general principles of treatment is urgently needed. The brain is unable to withstand oxygen deprivation from vital cells very long, and unless this is restored within a few minutes, irreversible brain damage is likely. If the heart has stopped beating, and breathing is diminishing or has also ceased, immediate steps at resuscitation are vital. Unless these two centers commence operating again, so allowing the blood flow to recommence and the blood to become reoxygenated, then the patient’s life is in grave peril.
Every first aider must have an intimate knowledge of the simple, effective methods of resuscitation and know how to commence these in a few moments. The first alder must know when they are needed, then how to carry them out. As these are fairly tiring, it is always advisable to have an assistant also conversant with the methods available to take over, so allowing periods of rest.
Loss of Consciousness Causes
It is always worth checking in the patient’s pockets, briefcase or handbag to see if there are any clues relating to possible disabilities. Sometimes patients with known chronic diseases (particularly diabetics, epileptics, heart cases) carry notification cards:
- Stating their disease, with phone numbers and instructions regarding emergency care or medical warning medallions or bracelets. These may be vital, so always check.
- Some cars have stickers with similar information, and glove boxes of cars may carry records.
Sometimes bystanders may be able to offer some indication of what occurred prior to the attack, and this may assist, such as in epileptics who may throw convulsions before lapsing into unconsciousness. See the sections on head injuries, stroke, fainting, epileptic fits, drunkenness, diabetic coma and hypoglycemic coma for some of the probable causes of unconsciousness. The treatment will be basically the same in each case but in some instances further treatment may be available
There are many causes of unconsciousness, but the immediate emergency treatment is the same. As soon as this has been carried out, the basic cause may be found, and sonic further treatment offered.
In any case, the sooner the patient is taken to expert medical attention (such as the emergency centre of a large hospital) the better. Many causes of unconsciousness are serious, necessitating urgent treatment.
Loss of Consciousness Symptoms
- The patient’s unconscious, and does not respond to normal stimulation, such as when spoken to or touched.
- There may be obvious causes present, such as hemorrhaging, vomiting, fluid loss from burns, diarrhea, or the obvious result from an accident.
- There may be eyewitness accounts of fits preceding the loss of consciousness. The patient may be a known diabetic, epileptic or heart patient. He or she may be an alcoholic.
- There may be evidence of what has caused the problem: sleeping-pill bottles, other medication containers, poison, drugs, bottles of alcohol, knives, guns etc.
What to Do in the Case of Unconsciousness
- Act promptly but remain calm and efficient. If you are scared and feel incompetent, call for immediate assistance. In any case, summon an ambulance for transport to hospital.
- Remove patient from the cause if further danger is imminent (e.g. electrical accidents).
- Turn patient on side. Make certain air passages are not blocked. If they are, remove any debris as a matter of urgency. Check for breathing and commence expired air resuscitation if necessary.
- Feel for pulse at neck if not present, immediate external cardiac compression is essential.
- If breathing and pulse are present, place the patient in the stable side position. This excellent position allows unwanted secretions (such as blood, vomitus, mucus or food) to drain from the body and reduces the risk of breathing obstruction.
- Check for bleeding and other injuries. Manage these.
- Under no circumstance give anything by mouth. This applies to fluid or alcoholic beverages. Oral administration could choke.
- Watch the patient’s color. A bluish color means inadequate oxygenation. A normal pink color means the patient is getting adequate amounts, and is in a far better position.
- Never leave the patient unless under adequate supervision of somebody with first aid or professional skill.
- Get medical aid as promptly as possible. Often, in serious cases, the emergency ward of a hospital is imperative. At this stage you do not know the cause, so plan for transportation promptly.
- Check in pockets, handbags or glove boxes for any identification of disease, as many chronics carry identification cards (or some other medical-warning device) setting out their disease, plus measures to be used in an emergency. These are often valuable.