Every minute that passes is uncertain. While we may prepare for prevention, unexpected events can always occur, especially concerning illnesses. The symptoms of various diseases often exceed our expectations. Once symptoms arise, every second that ticks away signifies the safety of life that we must urgently assist in preserving correctly. One of the common emergency conditions encountered in medicine is “unconsciousness.”
What is Unconsciousness?
“Unconsciousness” refers to a state where the patient’s body does not respond to the environment or show any reaction to stimuli, regardless of their intensity or potential to cause pain. This state is characterized by a continuous lack of awareness and an inability to regain consciousness spontaneously. Unconsciousness often has serious causes and is an emergency that requires immediate hospitalization.
What Causes a Patient to Become Unconscious?
Unconsciousness can occur due to various reasons, including:
- Head injuries causing severe brain trauma or damage, leading to impaired brain function.
- Stroke, which can result in reduced blood flow to the brain due to blocked blood vessels or severe bleeding within the brain.
- Heart conditions that do not provide enough blood to the brain.
- Severe hypoglycemia.
What Are the Symptoms of Unconsciousness?
An unconscious person will not respond to any stimuli, even vigorous shaking will not wake them. They will be unable to speak or move, even in response to painful stimuli. They may still breathe or exhibit difficulty breathing, gasping, or may stop breathing altogether. Bystanders must quickly assess the situation and provide urgent assistance, including calling for emergency medical services. Otherwise, the unconscious patient may not survive.
How to Save an Unconscious Patient?
Currently, there are training programs available for the public to learn basic life support techniques to assist unconscious individuals, known as “Basic Life Support” (BLS) or Cardiopulmonary Resuscitation (CPR). Training can be obtained at various hospitals. If assistance is provided within 4 minutes from when the patient stops breathing and is done effectively, it can prevent permanent brain damage due to lack of oxygen, offering the patient a chance to survive and return to a normal life.
Steps for Performing CPR on Adult Patients:
- Assess for unconsciousness by shouting loudly and shaking the shoulder, being cautious of any neck injuries. If unconscious, call for others to help.
- Call for assistance from others and request an ambulance, such as 1669 for emergency medical services or 1772 for Phyathai Hospital’s ambulance service.
- Position the patient lying on their back, carefully supporting their neck.
- Open the airway by pressing the forehead back and lifting the chin up; this will clear the airway.
- Check for breathing for about 10 seconds by leaning down close to the patient’s mouth and nose to listen and observe for any chest movement.
- If the patient is still breathing, position them in the recovery position by lying them on their side with one leg bent to prevent rolling over, using their arm to support the chin for airway clearance.
- If the patient is not breathing, perform rescue breaths by pinching the nose, sealing your lips over theirs, and blowing into their mouth until the chest rises for 1-2 seconds. Repeat to give 2 breaths, followed by chest compressions.
- For chest compressions, place the heel of one hand on the center of the chest, stacking the other hand on top, pushing down about 1.5-2 inches at a rate of 100 compressions per minute, alternating with rescue breaths (2 breaths followed by 30 compressions), continuing until the patient shows signs of life or help arrives.
- If unsure about the patient’s infectious status, or if they are not a close relative, chest compressions alone can be performed without rescue breaths at 100 compressions per minute until the patient breathes or help arrives.
If the patient regains consciousness or starts breathing independently, they should be placed in the recovery position and monitored until the ambulance arrives.
How is a Patient Who Becomes Unconscious Diagnosed Upon Arrival at the Hospital?
For unconscious patients, medical teams will initially assess their condition. If the patient is still unconscious, not breathing, or has a stopped heart, advanced resuscitation efforts will be undertaken using medications and life-support equipment, such as intubation, chest compressions, defibrillation, IV fluids, and medications.
If the patient regains consciousness, the doctor will further diagnose by:
- Taking a history from witnesses or relatives about prior health issues, medication use, or any accidents.
- Conducting a physical examination to determine the cause for treatment direction, particularly for stroke or heart issues.
- If stroke or heart disease is suspected, further tests such as MRI, ECG, or blood tests may be conducted to quickly identify the underlying cause, leading to appropriate treatment.
What Treatment Options Are Available for Unconscious Patients?
Doctors will determine treatment based on several factors, including:
- The patient’s symptoms
- Level of consciousness
- Vital signs
- The underlying cause of unconsciousness, such as large brain hemorrhages. If a clear cause is identified and symptoms are severe, urgent surgical intervention may be warranted.
What Care Should Be Provided at Home for Unconscious Patients?After treatment, some unconscious patients may still die, depending on the cause of their condition and whether basic life support was provided in time. However, if the condition stabilizes, some patients can recover and return to normal life.
Yet some patients may suffer severe brain damage, leading to loss of awareness, comprehension, response to stimuli, and movement. They may only exhibit basic actions such as blinking, laughing, or crying without meaningful communication, a condition often referred to as “vegetative state.” Once the underlying cause is treated, healthcare providers will prepare relatives for ongoing care at home, including:
- Monitoring breathing; many patients will require a tracheostomy tube for easier suctioning of secretions.
- Families must learn how to prepare food and administer tube feeding and medications.
- Caregivers should learn to prevent significant complications, such as repositioning to avoid bedsores, suctioning, and lung percussion to prevent pneumonia and atelectasis, as well as managing urinary catheters.
In addition to caregiver education, emphasis should be placed on preparing the living space and equipment for the patient’s safety and convenience, including:
- Establishing a downstairs living space for easy access.
- Ensuring the bed has side rails to prevent falls.
- Planning for caregiver shifts to allow for rest and reduce stress.
This is essential for the well-being of both the patient and the caregiver.
How to Protect Yourself from Unconsciousness?
The key to preventing unconsciousness is maintaining good health, as this reduces the risk of diseases and accidents that can lead to unconsciousness.
To live a happy life and avoid becoming a burden to loved ones, we should prioritize our health, adhere to the 10 principles of national health, and regularly check our health, including blood pressure, cholesterol levels, and blood sugar levels. If any health issues are discovered, it’s crucial to consult a physician and follow up on treatment to control any conditions before they lead to complications. With this approach, we can maintain good health.
