First Aid International

Unconsciousness

Definition

Unconsciousness is a state of unresponsiveness, where the casualty is unaware of their surroundings and no purposeful response can be obtained.

The brain requires a constant supply of oxygenated blood and glucose to function. Any interruption in this supply will cause loss of consciousness within a few seconds and permanent brain damage in minutes.

Causes of Unconsciousness

The causes of unconsciousness can be classified into four broad groups:

  • Blood circulation problems
  • Blood oxygenation problems
  • Metabolic problems (diabetes, overdoses)
  • Central nervous system problems (head injury, stroke, tumour, epilepsy)

One of the best ways to remember the common causes of unconsciousness is with a mnemonic called FISH SHAPED

Fainting
Imbalance of Heat
Shock
Head Injury

Stroke
Heart Attack
Asphyxia (choking)
Poisoning
Epilepsy
Diabetes

Positioning of the Unconscious Casualty

With an unconscious casualty, care of the airway takes precedence over any injury including the possibility of a spinal injury. All casualties' that are unconscious and breathing normally must be placed into the recovery position to:

  • Obtain and maintain a clear airway
  • Provide ready access to the airway
  • Facilitate drainage and lesson the risk of inhaling foreign material
  • Avoid unnecessary bending and twisting of the neck
  • Permit continuing observation of the casualty

Please note that a pregnant lady that is unconscious and breathing normally must be, where possible, be placed on their left side. This is to prevent the baby placing pressure on the main vein which will stop de-oxygenated blood coming back into the right side of the heart to be oxygenated. A good way to remember this is "Labour Left".

Fainting

Fainting is a common cause of unconsciousness and may occur when the casualty's heart rate is too slow to maintain sufficient blood pressure for the brain. This is a partial or complete loss of consciousness caused by a relative lack of blood flow to the brain.

Fainting usually occurs because of one of three processes:

  1. Siezure activity
  2. Inadequate supply to the brain (Low blood sugar)
  3. Inadequate oxygen supply to the brain

Signs and Symptoms

Fainting may occur with or without warning. The following signs and symptoms may occur:

  • Feeling light headed or dizzy
  • The signs of shock, such as pale, cool, moist skin
  • Nausea (Feeling Sick)
  • Numbness or tingling in the fingers and toes

Care and Treatment

Usually, fainting resolves itself. When the casualty collapses, normal circulation to the brain resumes. The casualty usually regains consciousness within a minute or two. Fainting does not usually harm the casualty; however injury can occur from falling onto the floor.

  • DRABCD (Primary Survey)
  • If the casualty responds, leave them on their back
  • If possible, raise the casualty's leg approx. 20-30cm
  • Loosen any restrictive clothing around the waist and neck
  • If the casualty is unresponsive, unconscious and breathing normally place them into the recovery position, call '000' and monitor their Airway and Breathing until help arrives.

Usually the casualty who faints will recover with no lasting effects. However, because you may not be able to determine whether the faint is linked to a more serious condition, the casualty should seek medical attention.

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