First Aid: Unconsciousness PDF

Chapter 3: Unconsciousness Mr. Fatima Farhat Objectives  1- Identify a victim showing signs of unconsciousness  2- Keep the unconscious victim’s airways clear pending the arrival of emergency assistance Consciousness Consciousness refers to the normal level of wakefulness which is de...

Chapter 3: Unconsciousness Mr. Fatima Farhat Objectives  1- Identify a victim showing signs of unconsciousness  2- Keep the unconscious victim’s airways clear pending the arrival of emergency assistance Consciousness Consciousness refers to the normal level of wakefulness which is dependent upon the interaction of a functioning cerebral cortex and an intact reticular activating system. 3 Character of Consciousness 1) Orientation to time, place, and person 2) Alert and awake 3) Awareness to the environment 4) Ability to answer questions appropriately 5) Intact recent and remote memory 4 Altered Level Of Conscious Confusion: Loss of the means to think clearly and quickly. Impaired judgement and decision making.  Disorientation: Disorientation to time or place. Impaired memory. Lack of recognition of self. Lethargy Restricted unprompted speech or movement. Easy to arouse by normal speech or touch. Potential disorientation to time, place or person. 5 Altered Level Of Conscious Coma : A state of complete unresponsiveness Lack of motor or verbal responses to external surroundings or to any stimuli. No response to noxious stimuli for example, deep pain. The person cannot be aroused at all by any stimulus. 6 UNCONSCIOU SNESS DEFINITION A victim is unconscious when he/she does not talk, react or move when asked, but is breathing normally. The causes of unconsciousness could be many: - Traumatic - Medical - Toxic Causes of Altered Consciousness Seizure Cerebrovascular causes Tumor Cardiac arrest Heart or lung disease Asphyxiation Alcohol Carbon monoxide Drugs Infections 8 Pathophysiology Direct compression or destruction of the structures Decrease in availability of oxygen or glucose Toxic effects of substances on the structures of the RAS UNCONSCIOUSNESS 9 UNCONSCIOUSNESS Risk  The risk posed by unconsciousness is the progression to respiratory and circulatory arrest. In fact, one cannot breath unless the airways are clear.  Someone unconscious, if left on their back, is always prone to respiratory difficulties due to congestion or obstruction of the airways from: - Liquids in the throat (saliva, blood, gastric liquid) - The tongue falling back 3 The priority is to open the 4 airways. 10 (airways obstruction) tongue falling back 3 5 11 Assessment Look: ALERTNESS ( AVPU scale): shake the shoulder , call loudly, look for chest movement Listen: Heart Sound Feel: Air passage through nostril 12 13 Check Consciousness 3 7 14 First Aid Management If No heart sound and no breathing (cardiac arrest) 1- Start Cardiopulmonary Resuscitation Call For help Chest Compression 15  2- RESCUE BREATHING OPENING THE AIRWAY Place the victim on their back Immediately make sure that the airways are open: Tilting the head, chin lift, Jaw thrust Cover your mouth completely on patient mouth Deep breath 2 times Airways opening for adults and children -Place the palm of one hand on the forehead of the victim. -Place 2 or 3 fingers of the other hand, just below the chin tip, pressing on the bone and not on the soft part of the chin. Slightly tilt the victim’s 3 8 head backwards pressing on the forehead and lifting the chin, place 16 your thumb on the chin to open the mouth. UNCONSCIOUSNES S OPENING THE AIRWAY Note : Remove visible solids inside the victim's mouth with the hand (crossed fingers technique and finger sweep technique) 3 9 17 1 2 3 Remove one hand on pressing on solid the the bone and forehead not on the soft part of the chin 4 0 18 open the 4 Check the breathing 12 Recovery position Safe place Left lateral Chin up and keep right hand under the chin Right leg folded upto abdomen Left leg straight Continuous monitoring Refer to hospital 20 21 RECOVERY POSITION Recovery Position Key points: Putting the victim in the recovery position must: 1. Limit as much as possible all movements of the spine to prevent any deterioration of a possible lesion in the spinal cord that could lead to paralysis or death. 2. Adopt the most stable lateral position to prevent the victim from falling on their back or their belly and maintain the spine as straight as possible. 3. Not cause any pressure on the chest not to restrict the victim’s respiration. 4. The head must be tilted and the mouth open to ensure that the 14 airways are open and all the liquids will flow outward. RECOVERY POSITION Recovery Position for adults and children o Preparing to turn the victim  Remove the victim’s glasses if any.  Put the victim’s arm, closest to the rescuer’s side, in a right angle with his/her body.  Kneel down next to the victim.  Hold the victim’s opposed arm with one hand and place the back of the hand against his/her ear from the rescuer’s side  Maintain the victim’s hand pressed against the ear.  Hold the opposed leg with the other hand, just behind the  knee, liftyourself Position it as far as possible from the victim on the level 4 keeping of thoraxthe footable to be on the ground. to turn him/her on his/her side without 5 23 being obliged to move back. RECOVERY POSITION o Turning the victim  Roll the victim with his/her shoulder or elbow and knee at the same time toward you with minimal movements until the knee and elbow both touch the ground.  Be sure to preserve the head tilted backwards after turning the victim on his/her side. 16 RECOVERY POSITION o Stabilize the victim  Adjust the leg situated above so as the hip and the knee form in right angle to stabilize the position.  Open the mouth with the thumb and forefinger of the hand without moving the head in order to allow the flow of liquids to the outside. 17 Recovery position 26 UNCONSCIOUSNE SS D) Alert Ask someone to notify or notify emergency services :  If the rescuer is alone and without a phone, and after placing the victim in recovery position, they could leave the victim to notify emergency services as quick as possible.  If the rescuer is not alone, they should make sure that a bystander contacts emergency services.  Protect the victim from the cold, the heat, or bad weather  Watch the victim pending the arrival of emergency services  The rescuers watch the victim’s breathing. They look to the chest rise, listen for the possible breathing sounds or place their hand on the patient’s chest to feel the movement of the chest. If breathing ceases the rescuer must quickly reposition the victim and 4 place them on their back and start doing CPR maneuvers (see the 9 chapter on “Cardiac Arrest”). 27 EXCEPTION Pregnant woman: Place the pregnant woman in the recovery position on the left side to prevent any distress due to the compression on certain blood vessels in the abdomen that would affect her wellbeing. 20  EXCEPTI ON Infants: (new born) 1 Check the infant’s consciousness: tap the infant’s shoulder or flick the bottom of the infant’s foot. 2 To open the victim’s airways proceed with the same method as for an adult and child but stop the head backward tilt once the newborn baby’s face is parallel to the sky. Note : Unlike an adult patient, tilting the head of an infant backwards will cause an infant’s airways to close. 21 EXCEPTION 3 Check the victim’s breathing by scanning the infant’s chest rise and fall for no more than 10 seconds. 4 Place the unconscious infant breathing normally on their side. They can be kept in this position in the arms of the rescuer. The infant should be facing your thorax to be able to monitor the infant’s condition for any deterioration. 22 neutral position of a newborn’s head 23 Thank you…. 32