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Unconsciousness

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Unconsciousness is potentially life-threatening. An unconscious person is in danger of choking from vomit, saliva or blood because the normal reflexes such as coughing are not effective. If the person is lying face upwards, there is a danger that the tongue or throat soft tissue may obstruct the airway.

States of unconsciousness range from a brief period of fainting to a deep and prolonged coma. It has many possible causes, such as poisoning, epilepsy, suffocation, bleeding, head injury, stroke, heart attack, diabetes and alcohol and drug overdose.

Signs
An unconscious person:

  • Is unaware of his surroundings and does not respond to sound
  • Makes no purposeful movements
  • Does not respond to questions or to touch
  • May or may not be breathing or have a pulse

Get help immediately if:

  • A person is unconscious for more than a few seconds.
  • The person is not breathing or has no pulse.

Call a doctor even if the person has regained consciousness. The person must be fully examined.

Immediate care

  • To determine whether a person is unconscious or not, ask with a loud voice: Are you OK? If there is no response, tap on the chest or shoulder or gently shake the shoulders to see whether he responds and ask again. (If you suspect a head or neck injury, do not shake the shoulder). In the case of a baby, tap the feet.
  • Check the ABC: Airway, breathing and circulation. If the person is not breathing, start mouth-to-mouth breathing. If there is no pulse, start full CPR.
  • If choking is suspected, do the Heimlich manoeuvre.
  • If you do not suspect a head or spinal injury, move the person into the recovery position. This will prevent the airway from being blocked by the tongue, blood or vomit.
  • Look for a Medic-Alert tag that may explain the cause of the unconsciousness.
  • Look and treat for any obvious injuries, such as fractures or bleeding.
  • Keep the person warm. Do not give anything to eat or drink when the person awakes.
  • Monitor the level of response, breathing and pulse regularly until medical help arrives. Note: If a back or neck injury is suspected, do not move the person.

Fainting
Fainting occurs when there is a temporary drop in blood flow to the brain. It is nature’s way of ensuring that the brain immediately receives oxygen-rich blood. When you fall or lie down, blood flow is improved and you regain consciousness.

A fainting episode usually lasts no more than a minute or so. It is not usually serious.

If someone has fainted, check to see that the airway is open. To help blood reaching the brain, let the person lie flat and elevate the legs. Loosen any tight clothing around the neck. Do not prop the head up as this could obstruct breathing. Gently wipe the face with a cool, wet cloth.

Once the person comes to, keep him or her lying down for a few minutes, because getting up too rapidly could lead to another fainting episode. A person who has fainted will often feel nauseous afterwards. If the person vomits, help the person into the recovery position.

Fainting is usually not serious and may be because of emotional shock, panic, being in a stuffy room, standing for too long periods or skipping meals. However, it may sometimes be a sign of an underlying condition. If the person is elderly, has a heart problem, is diabetic, or if the fainting happens often, a doctor should be consulted. If you suspect that the person’s fall resulted in any type of injury, such as a head injury, a doctor should also be consulted.

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