http://www.ambulance-service.org.uk/index-A1.html

DEVELOPMENT CLASS

UNCONSCIOUS PATIENT

 

UNCONSCIOUSNESS

Unconsciousness is fundamentally a sign of impairment of the activity of some or all of the brain.

 

THE MAIN CAUSES OF UNCONSCIOUSNESS

 

·            C – cardiac arrest

·            H – head injury

·             I -  infantile convulsion (febrile)

·            E – electric shock

·            F -  faint

·            S -  stroke (CVA)

·            A -  asphyxia - hypoxia

·            P -  poisons

·            H -  hypothermia/Hyperthermia

·            E -  epilepsy

·            A -  Asthma

·           D -  diabetes

 

REMEMBER

·           A clear airway must be maintained

·           If there are obvious signs of obstruction, It must receive priority treatment as it will kill in a matter of minutes.

 

MANAGEMENT OF THE UNCONSCIOUS PATIENT

 

PRIMARY SURVEY

·           Checking for hazards to yourself and the patient

·           Noting obvious signs and position of the patient

·           Speaking to the patient and applying stimulus (painful if necessary to assess the level of consciousness)

·           Ensuring an open airway

·           Checking breathing

·           Checking the pulse

 

Deal with any life threatening problems first, and if these allow progress to the secondary survey. (see page 2)

 

UNCONSCIOUS PATIENTS

 

SECONARY SURVEY

 

HEAD CHECK

·           Skull for irregularity or scalp wounds

·           Ears for fluid (blood – CSF)

·           Eyes for pupil size and reaction

·           Lips for colour (cyanoses)

·           Jaw for displacement

·           Mouth for loose teeth or abnormal staining

·           Airway and insert oro-pharyngeal airway

·           Skin; colour (pale or flushed)

                        Texture (dry or moist)

                        Temp. (hot or cold)

 

THORAX CHECK

·           Clavicals for fractures

·           Sternum for fractures

·           Ribs for fractures

 

 

ABDOMEN CHECK

·           Pelvis for fractures, abnormal movements or guarding

·           Groin for dampness

 

 

BACK CHECK

·           Spine for irregularity

·           Scapulas for fractures

 

 

LIMB CHECK

·           Irregularity, deformity and fractures

·           For flexion of the joints (if no injuries)

·           For signs of drugs abuse (needle marks)

 

 

IDENTIFICATION CHECK

·           Identification, medical cards or bracelets

 

 

 

 

UNCONSCIOUS PATIENT

PATIENT POSITIONING

Having examined the patient and decide there is no injuries to be cared for, or you have treated any injuries, you may place the patient: -

 

·           In the recovery position

·           In the ambulance, continue observation

 

There may be occasions when it is not possible or desirable to transport an unconscious patient in the recovery position. If this is the case: -

 

·           Insert an oro-pharyngeal airway

·           Continue constant observation of the airway

·           Keep suction equipment handy

·           Use postural drainage position

·           Apply cervical collar, if head injury present, (or spinal injury)

 

 

CONTINUE TO OBSERVE

 

·           Airway

·           Respiratory rate/rhythm/depth (Administer 100% Oxygen)

·           Pulse rate/volume – Place on Cardiac Monitor

·           SPO2

·           Blood Pressure

·           Bleeding is arrested

·           facial colour

 

 

REMEMBER

             Never leave an unconscious patient unattended

       In unconsciousness hearing is the last sense to be lost and the first to return. 

       So talk to the Patient.