Causes of Unconsciousness
The causes of unconsciousness can be classified into four broad groups:
• low brain oxygen levels
• heart and circulation problems (e.g. fainting, abnormal heart rhythms)
• metabolic problems (e.g. overdose, intoxication, low blood sugar)
• brain problems (e.g. head injury, stroke, tumour, epilepsy).
Combinations of different causes may be present in an unconscious person e.g. a head injury due to the influence of alcohol. Recognition Before loss of consciousness, the person may experience yawning, dizziness, sweating, change from normal skin colour, blurred or changed vision, or nausea. Assess the collapsed person's response to verbal and tactile stimuli (‘talk and touch’), ensuring that this does not cause or aggravate any injury.
This may include giving a simple command such as, “open your eyes; squeeze my hand; let it go”. Then grasp and squeeze the shoulders firmly to elicit a response. A person who fails to respond or shows only a minor response, such as groaning without eye opening, should be managed as if unconscious.
Management If the person is unresponsive and not breathing normally, follow ANZCOR Basic Life Support Flowchart (Guideline 8). Start CPR
With an unconscious normal breathing person, care of the airway takes precedence over any injury, including the possibility of a spinal injury (Guideline 9.1.6).
An unconscious person must be handled gently and every effort made to avoid any twisting or forward movement of the head and spine. ANZCOR suggests that an unresponsive person who is breathing normally be positioned into a lateral, side-lying recovery (lateral recumbent) position as opposed to leaving them supine.
• Ensure the safety of both the person and rescuer.
• Assist the unconscious person to the ground and position them on the side. Ensure their airway is open (Guideline 4).
• Do not leave the person sitting in a chair nor put their head between their knees.
• Call an ambulance.
• Promptly stop any bleeding (Guideline 9.1.1).
• Constantly re-check the person’s condition for any change. 6. Ideally, the most experienced rescuer should stay with the person.