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Unconscious Unresponsive Patient
When dealing with an unconscious unresponsive patient you will want to follow the
of CPR and First Aid
Someone who is unconscious is not sleeping. Rather, an unconscious person is hard to rouse or can't be made aware of his or her surroundings. Unconsciousness is caused by illness, injury or emotional shock.
Signs and Symptoms
There are many levels of unconsciousness. Some are more serious than others. Levels include unconscious episodes that are:
Brief - Examples are fainting or blacking out.
Longer - The victim is incoherent when roused.
Prolonged - A person in a coma, for example, can be motionless and not at all aware of his or her surroundings for a very long time.
Causes of Unconsciousness
Extremes of Body Temperature
Poisonous Substances and Fumes
Management of The Unconscious Patient
An unconscious patient is unable to give an account of what has happened to them. Try and gain as much history from those at the scene and from any injuries sustained as to what may of happened.
anger - Looking for Dangers to yourself and Casualty
esponse - Checking Response (AVPU). Use the
Glasgow Coma Scale
to ascertain level of consciousness
irway - Examining the Airway for obstruction and Cervical Spine Control in the event of any possible trauma
reathing - Look, Listen and Feel for adequate respiratory effort. Supplement with O2 to correct hypoxia if saturations are below 95%
irculation - Checking the Circulation. If a carotid pulse is not palpable then resuscitation should be commenced
Rectify any problems encountered in your primary survey before moving onto your secondary survey
Skull for irregularity or scalp wounds
Ears (blood or CSF)
Eyes for pupil size and reaction (PEARL)
Lips for color (cyanosed)
Jaw for displacement
Mouth for loose or missing teeth or bitten tongue (Epilepsy)
Skin color, texture and temperature (Flushed, Dry and Hot) etc
Clavicles for bruising and possible fractures
Ribs - fractures and abnormal breathing
Rigidity and guarding
Pelvis fractures or abnormal movement
Groin for dampness
Irregularity, deformity and fractures (compare limbs with each other)
Flexion and extension without aggravating any injury
Signs of drug abuse (Needle marks)
Capillary refill and distal pulses
Scapulae for fractures
Spine for irregularities
If not done so already look for any form of identity, cards or bracelets
Before moving onto each section on the secondary survey check the patients ABC's
Collate as much information as possible about the patient
igns & Symptoms
ast pertinent medical history (Epilepsy, Diabetes)
vents leading up to the illness or injury- What has happened?
Vital Signs - Monitor
Blood Glucose Levels (Correct hypoglycaemia with Glucagon/Hypostop if required)
Oxygen Saturation (SP02)
Treat any obvious injuries e.g. bleeding, fractures (support and immobilize)
Continue to Observe:
Even though the patient may appear unresponsive it doesn't mean they can't hear you. Keep talking to the patient as hearing is the last sense lost.
In the unconscious patient, after the airway is opened the next area to assess is the patient's breathing,
] primarily to find if the patient is making normal respiratory efforts. Normal breathing rates are between 12 and 30 breaths per minute,
] and if a patient is breathing below the minimum rate, then in current ILCOR basic life support protocols, CPR should be considered, although professional rescuers may have their own protocols to follow, such as
Rescuers are often warned against mistaking
, which is a series of noisy gasps occurring in around 40% of cardiac arrest victims, for normal breathing.
If a patient is breathing, then the rescuer will continue with the treatment indicated for an unconscious but breathing patient, which may include interventions such as the
and summoning an
UNCONSCIOUS Standing Order.pdf
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