First Aid Basics: How to Assist the Unconscious Patient

Before you can determine if a person is unconscious, check that they are in fact unconscious and have not simply fainted. Once you have determined that the person has not fainted, asses the level of consciousness by speaking loudly to the patient, if there is no reaction, gently pat the patient on the cheek, and finally if there is still no reaction, inflict a sharper pain by pinching. Before starting any treatment, you need to immediately check the vital signs by following the A (Airways) , B (Breathing), C (Circulation). A is for Airways

  1. The airway may be obstructed either by a foreign object or a relaxed tongue.
  2. To prevent inhalation of vomit the mouth must be cleared out, wear protective gloves to do this and with two fingers wipe the patients mouth out. Ensure that the patients jaw is locked during this procedure to avoid injury to your fingers.
  3. Tilt the patients head back leading to a lifting of the jaw and therefore the tongue. the airway is now open. This manoeuvre is referred to as the head tilt manoeuvre. as this is a life saving treatment, it must be carried out carefully even if spinal injuries are suspected.

B is for Breathing

  1. To assess how a person is breathing and how the breathing develops, keep the patients head in a tilted position.
  2. Place one ear over the patients mouth and nose so you can hear their breathing, place a flat hand on the patients chest so that you can feel them breathing and watch the chest so that you can see them breathing.

C is for Circulation

  1. The pulse is best taken on the patient’s carotid arteries, which are next to the voice box, one on each side of the neck. Check both if necessary

Once all vitals have been assessed the patient must be treated immediately while a bystander calls for professional assistance. If the patient is unconscious  only, but breathing and with circulation present, the treatment must ficus on preventing suffocation due to relaxing of the tongue or inhalation of vomit. Turn the patient into the recovery position. You will not require CPR or artificial ventilation if the patient is breathing spontaneously and the heart beating. Once put into the recovery position continue checking and monitoring the vital signs so that you can react quickly if anything changes. If the patient’s unconscious and their respiration has failed, attempt to find a pulse, should the heart still be beating , artificial ventilation must be commenced immediately. The treatment must be interrupted every minute to assess if circulation is still adequate. As long as the heart continues beating CPR is not required. Artificial ventilation may be given via the patients mouth or nose. For infants it should be done via both the mouth and nose.  Both the breathing pace and lung capacity of the patient should be taken into account:

  • 0 to 2 years old: +- 50 ml:  45 to 55 times per minute
  • 3 to 6 years old: 60 to 300ml: 25 to 40 times per minute
  • 6 to 12 years old: 300 to 400ml: 20 to 25 times per minute
  • 12 years and older: 400 to 800ml: 10 to 20 times per minute

To insure effectiveness try to feel a build up or resistance of the lung tissue, remember to wait for the patient to exhale before assisting with the next inhalation.  For drowning, use the same procedure but do not waste time on trying to expel any water from the lungs, this will come out during the patients exhalation. If a person is unconscious, their respiration and circulation have failed, start CPR ( click to find out how to perform CPR).

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