How to Assess the Level of Consciousness During a First Aid Procedure

2024 Author: Samantha Chapman | [email protected]. Last modified: 2023-12-17 09:13

Being able to assess a person's level of consciousness during an emergency situation can help 911 telephone operators and potentially save precious minutes when help arrives. There are several techniques to determine the state of consciousness or try to stabilize an unconscious person while waiting for medical intervention.

Steps

Part 1 of 3: Assessing the Consciousness Level of a Reactive Person

Step 1. Analyze the circumstances

The first thing to do in any emergency is to stop and assess the situation. Try to understand what caused the victim's injury and whether it is safe to approach. There is no help rushing in before the danger is completely gone - you can't help one person if you become a victim of the same accident yourself, and the emergency services have no need to save two people instead of one.

Step 2. Recognize the symptoms of a person who may be on the verge of losing consciousness

Among these are:

• Slurred speech (dysarthria)
• Tachycardia;
• Confusional state;
• Dizziness;
• Stunning;
• Sudden inability to respond consistently or to respond at all.

Step 3. Ask the victim questions

Asking a series of questions immediately gives you a lot of information about his health. They must be simple questions that require a certain level of cognition. Start by asking the person if they are okay, to see if they are responsive. If she responds or even simply complains to show you that she is not unconscious, try asking her:

• Can you tell me what year it is?
• Can you tell me what month we are in?
• What day is it?
• Who is the President of the Republic?
• Do you know where you are?
• Do you know what happened?
• If he answers you clearly and consistently, it means that he is perfectly conscious.
• If he answers you but many statements are wrong, he is conscious but shows signs of what is called an altered state of consciousness, which includes confusion and disorientation.

Step 4. Call 118

If the victim is conscious but in a confused state (for example, unable to answer simple questions clearly), you should call for help immediately.

• When on the phone, inform the operator of the victim's level of consciousness using the AVPU rating scale:

  • TO: alert, the victim is alert and oriented;
  • V.: verbal, responds to verbal stimuli;
  • P.: pain (pain), reacts to the stimulus of pain;
  • U: unresponsive (inert), the victim is unconscious / unresponsive.

• Even if he answers all questions consistently and shows no signs of altered state of consciousness, you must still call the ambulance if the victim:

  • Shows other injuries due to the traumatic event;
  • Experience chest pain or discomfort
  • Have an irregular or pounding heartbeat
  • He reports vision difficulties;
  • He is unable to move his arms or legs.

  

  Step 5. Proceed to other questions

  This is useful for trying to catch other clues and understand what may have led the person to faint or to reduce the state of consciousness. The victim is not always able to answer all the questions, based on his level of awareness and reactivity. Try asking her:

  • Can you tell me what happened?
  • Are you taking any medications?
  • Are you diabetic? Have you already experienced a diabetic coma experience?
  • Have you taken any drugs or drank alcohol (pay attention to any needle marks in your arms / legs or look around if you notice any drug bottles or alcohol bottles nearby)?
  • Do you suffer from any pathology that creates seizures?
  • Do you have heart problems or have you already had a heart attack?
  • Did you have chest pain or other symptoms before the accident?

  

  Step 6. Make a note of all of the injured person's responses

  Regardless of whether they are logical or not, they are however helpful for the 118 telephone operators to determine the best way to proceed. If necessary, write down everything so that you can report it to the healthcare professional exactly as the victim told you.

  • For example, if the victim has given you gibberish answers to most of the questions, but has also told you that he is suffering from seizures, it is quite normal for him to keep answering you inconsistently for another 5-10 minutes after the critical phase. but it may still need more than a short period of observation by medical personnel.
  • Another example would be if the victim has confirmed to you that she is diabetic; By providing this information to the telephone operator, rescuers already know they will need to check blood glucose levels immediately upon arrival.

  

  Step 7. Get the victim to talk to you

  If she gave you the wrong answers to all the questions - or they were logical, but you feel like she's on the verge of falling asleep - you need to do whatever it takes to get her to talk. It will be much easier for medical personnel to assess the situation if they are conscious. Ask the person if he is able to keep his eyes open and ask him other questions to encourage him to talk.

  

  Step 8. There are other common causes of unconsciousness

  If you know that the victim "passed out" or some witnesses told you about it, you can provide medical personnel with information so that they can diagnose or understand the cause of the loss of consciousness. Among the most common are:

  • Severe bleeding;
  • Severe head or chest trauma;
  • Overdose;
  • Drunkenness;
  • Car accident or other serious injury;
  • Problems with blood sugar (such as diabetes)
  • Heart disease;
  • Hypotension (common among the elderly, although they often regain consciousness rather quickly);
  • Dehydration;
  • Convulsions;
  • Stroke;
  • Hyperventilation.

  

  Step 9. Check if the victim is wearing a medical necklace or bracelet

  In many cases, patients with chronic conditions, such as diabetes, wear a piece of information on their state of health, which is useful for medical personnel who intervene in an emergency.

  If you notice that the victim is wearing one, report it immediately to the doctors when they arrive

  

  Step 10. Monitor the casualty until paramedics arrive

  It is important that someone is present to observe him constantly.

  • If he remains in a semi-conscious state, breathing and other vital signs seem regular, keep checking him until the ambulance arrives.
  • If the victim starts not reacting, it means that the situation is getting worse, so you need to evaluate it further and proceed with the steps described below.

  Part 2 of 3: Evaluating an Unconscious Person

  

  Step 1. Try to wake her up by making a loud noise

  Try yelling "Are you okay?" and shake it gently. This may be all it takes to bring her back to a state of consciousness.

  

  Step 2. See if he reacts to pain

  If she doesn't answer your questions, but you're not sure if she's unconscious enough to have cardiopulmonary resuscitation (CPR), you can see how she reacts to the pain stimulus.

  • The most common technique is "sternum rubbing", which consists of putting the hand into a fist and using the knuckles to vigorously rub the breastbone. If the victim reacts to the "pain" - this feeling - you can continue to monitor them without the need for CPR, as their behavior is enough to understand that all is well for now. However, if the victim is inert, you will likely need to proceed with CPR.
  • If you are concerned that the victim has some form of chest injury from the trauma, you can use other methods to check their pain response, such as squeezing their fingernail or nail bed or pinching their trapezius, the muscle in the back of their neck.. Make sure you apply strong pressure directly on the muscle.
  • If the victim reacts to pain by pulling the limbs towards the body or outwards, you may be faced with spasms, an involuntary response that may indicate a spinal or brain injury.

  

  Step 3. Make sure you called 911

  You probably have already done so, but you need to be sure that the ambulance is on its way, especially if the victim hasn't reacted to the pain. Stay on the phone with the carrier or if there is someone else nearby give them the phone so that they will receive further instructions on how to proceed.

  

  Step 4. Check if the victim is breathing

  If you are unconscious but breathing, you do not need to do CPR, especially if you have not been properly trained to do it.

  • Be sure to constantly check if your chest rises and falls to make sure you are still breathing.
  • If you can't tell simply from observation, put an ear near the victim's mouth or nose and listen for the sounds of the breath. When you hear the breath from his mouth, direct your gaze towards his body to check that his chest is moving in sync with the breathing. This is the simplest way to tell if you are breathing.
  • Remember that if you have any reason to suspect a spinal injury, but the victim is breathing, do not try to reposition it unless he vomits. In this case, roll her onto her side, supporting her neck and back to keep them aligned.
  • If, on the other hand, there is no reason to fear a spinal injury, roll the victim onto their side, bend their upper leg so that the hip and knee are at 90 ° (to stabilize the victim on their side) and then tilt them. gently her head back to open her airways. This is called the "lateral safety position" and is the safest position for a victim in case you start vomiting.

  

  Step 5. Check your heart rate

  You can feel it on the underside of the wrist towards the thumb and it is called the "radial pulse", or by gently touching one side of the neck about 3 cm below the ear, called the "carotid pulse". Always check the arterial pulse on the same side of your body as you are. By bending over the victim to reach the other side of the neck, you may scare them if they wake up.

  • When you do not feel the heartbeat and, above all, when the victim is not breathing, it is time to perform cardiopulmonary resuscitation, if you have been trained to practice it; if not, follow the instructions given to you by the medical staff over the phone.
  • If you accidentally hung up the phone after making the call, you can always call back for further instructions. The switchboard staff has been trained and trained to provide all information to non-experts.

  Part 3 of 3: Treating an Unconscious Person until Medical Staff Arrive

  

  Step 1. Ask someone present if they can do CPR

  Cardiac arrest is one of the main reasons that lead to loss of consciousness when there are no other obvious causes, such as a car accident. Performing CPR (if necessary) until medical personnel arrive gives the victim double or even triple the chance of survival in the event of cardiac arrest. Check to see if anyone nearby has been properly trained to perform it.

  

  Step 2. Check the victim's airways

  If he is not breathing or has stopped breathing, the first thing to do is check his airway. Place one hand on your forehead and the other under your jaw. With your hand on your forehead, slide your head back and raise your jaw with the other; check every movement of the chest if it starts to rise and fall. Put one ear over your mouth to feel the air on your cheek.

  • If looking inside the victim's mouth you can see something obstructing the airway, try to remove it, but only if it is not stuck. If it is clearly stuck, you shouldn't try to get it out of your throat, or you may inadvertently push it even deeper.
  • The reason why it is important to look at the airways right away is because if there is any foreign object (or an obstruction, as is often the case in choking victims) and if you can easily remove it, you have solved the problem.
  • However, if the ways are open, check your pulse; if there is no heartbeat (or can't find it and have doubts), start chest compressions immediately.
  • You must not bow the head and lift the chin of a victim who has sustained injury to the skull, spine or neck; in this case, perform sub-dislocation of the jaw, kneeling above the victim's head, with both hands on either side of his head. Place your middle and index finger along the jawbone and gently push it upwards, so that the jaw protrudes forward, a bit as if it has an undershot bite.

  

  Step 3. Perform chest compressions

  The current CPR protocol emphasizes the importance of chest compressions in a ratio of 30 compressions for every two artificial respirations. To start the procedure:

  • Place the palm of your hand on the victim's breastbone directly between the nipples;
  • Place the palm of the other hand over the back of the first;
  • Place your body weight directly over your hands;
  • Push down energetically and quickly, so that the chest goes down about 5 cm;
  • Let the chest rise completely again;
  • Repeat 30 times;
  • At this point, give two artificial breaths if you know how to perform CPR; otherwise, continue with the compressions and let go of the breath, which is much less important.

  

  Step 4. Check for signs of breathing again (check approximately every two minutes to see if victim is breathing)

  You can stop CPR as soon as the person shows that he is able to breathe on his own. See if his chest rises and falls and put an ear near his mouth to see if he can breathe on his own.

  

  Step 5. Continue cardiopulmonary resuscitation until doctors arrive

  If the victim does not regain consciousness or is unable to breathe on his own, you must persist with CPR at a ratio of 2 artificial breaths every 30 chest compressions until the ambulance arrives.