Sec1.fa5 disorders of consciousness

UNCONSCIOUSNESS

An interruption of the brain’s normal activity

Major Causes

Head injury

Stroke

Fainting

Heart Attack

Shock

Poisoning

Hyperglycemia

Hypoglycemia

Fits

Abnormal body temperature

EXAMINING & TREATING AN UNCONSCIOUS CASUALTY

Aims of treatment

To maintain an open airway.

To assess and record the level of response.

To treat any associated injuries.

To arrange for urgent removal to hospital if necessary.

To gather and retain any circumstantial evidence of the cause of the condition.

EXAMINING & TREATING AN UNCONSCIOUS CASUALTY

Aims of treatment

DO NOT attempt to give anything by mouth.

DO NOT move casualty unnecessarily.

DO NOT leave casualty unattended at any time.

LEVELS OF RESPONSE

A - alert

V - voice

P - pain

U - unconscious

HEAD INJURIES - CONCUSSION

HEAD INJURIES - CONCUSSION

Recognition

Brief or partial loss of consciousness.

Dizziness or nausea on recovery.

Loss of memory of events at the time of injury or immediately before the injury.

A mild, generalised headache.

HEAD INJURIES - CONCUSSION

Treatment

Place an unconscious casualty in the recovery position.

Monitor and record breathing, pulse and level of response every ten minutes.

Call for an ambulance if the casualty is still unconscious after 3 minutes.

If casualty regains consciousness within 3 minutes, watch closely for any deterioration in the level of response, even after an apparent full recovery.

HEAD INJURIES - CONCUSSION

Treatment

Place the casualty in the care of a responsible person.

Advise the casualty to see a doctor.

HEAD INJURIES – SKULL FRACTURE

Recognition

A wound or bruise on the head.

A soft area or depression of the scalp.

Impairment of consciousness.

A progressive deterioration in the level of response.

Clear fluid or watery blood coming out from the nose or ears.

Blood in the white of the eye.

Distortion or lack of symmetry of the head or face.

HEAD INJURIES – SKULL FRACTURE

Treatment

Check ABC if casualty is unconscious.

Help a conscious casualty to lie down with the head and shoulders raised.

If there is discharge from an ear, position the casualty so that the affected ear is lower.

Cover the ear with a sterile dressing or clean pad, lightly secured with a bandage. DO NOT plug the ear.

Control any bleeding from the scalp.

HEAD INJURIES – SKULL FRACTURE

Treatment

Look for and treat other injuries.

Call for an ambulance.

Monitor and record breathing, pulse and level of response every ten minutes.

HEAD INJURIES – COMPRESSION

Occurs when pressure is exerted on the brain within the skull.

Recognition

As the condition develops, the level of response will deteriorate.

A recent head injury, followed by an apparent full

recovery. Later on, casualty may deteriorate and become disorientated.

An intense headache.

Noisy breathing, becoming slow.

Recognition

A slow yet full & strong pulse.

Unequal or dilated pupils.

Weakness or paralysis down one side of the face

or body.

High body temperature, flushed face.

Drowsiness.

A noticeable change in personality or behaviour, such as irritability.

HEAD INJURIES – COMPRESSION

HEAD INJURIES – COMPRESSION

Treatment

Call for an ambulance.

Check for ABC & perform CPR if necessary.

Stop any bleeding.

Place in recovery position.

If casualty is conscious, support him or her in a comfortable position.

Monitor & record breathing, pulse and level of response every 10 minutes.

FITS (CONVULSIONS)

Involuntary contractions & relaxation of muscles

in the body repeatedly due to disturbance in the function of the brain.

Possible causes

Head injury.

Some brain-damaging diseases.

Shortage of oxygen to the brain.

Intake of certain poisons.

FITS (CONVULSIONS) – MINOR EPILEPSY

Recognition

Sudden “switching off”, casualty may be staring blankly ahead.

Slight or localised twitching or jerking of the lips, eyelids, head or limbs.

Odd involuntary movements such as chewing or making noises.

FITS (CONVULSIONS) – MINOR EPILEPSY

Treatment

Help the casualty to sit down in a quiet place.

Remove any possible sources of harm.

Talk to casualty calmly and reassuringly.

DO NOT pester casualty with questions.

Stay with casualty until someone take over you.

Advise the casualty to see a doctor.

FITS (CONVULSIONS) – MAJOR EPILEPSY

Recognition

Casualty suddenly falls unconscious, often letting

out a cry.

Becomes rigid, arching his or her back.

Breathing may cease.

May have cyanosis of lips.

Face and neck may be congested.

Fit movements begin. The jaw may be clenched and breathing may be noisy.

FITS (CONVULSIONS) – MAJOR EPILEPSY

Recognition

Saliva may appear at the mouth.

Possible loss of control of bladder or bowel.

Recovers consciousness within a few minutes.

May be followed by a deep sleep.

May be evidence of injury.

FITS (CONVULSIONS) – MAJOR EPILEPSY

Treatment

If you see casualty falling, try to support him or her. Make space around him and ask bystanders

to move away.

Loosen clothing around casualty’s neck.

If possible, protect his or her head.

When the fit stops, place casualty in recovery position.

Check breathing and pulse.

FITS (CONVULSIONS) – MAJOR EPILEPSY

Treatment

Stay until casualty recovers fully.

If unconscious for more than 10 minutes or fit for more than 5 minutes, call for an ambulance.

FITS (CONVULSIONS) IN YOUNG CHILDREN

Possible Causes

Infectious disease.

Throat or ear infection associated with a greatly raised body temperature or fever.

FITS (CONVULSIONS) IN YOUNG CHILDREN

Recognition

Clear signs of fever: hot, flushed skin and perhaps sweating.

Violent muscle twitching with clenched fists and arched back.

Twitching of face with squinting, fixed or upturned eyes.

Breath-holding, with congested face and neck or drooling at the mouth.

Loss of or altered consciousness.

FITS (CONVULSIONS) IN YOUNG CHILDREN

Treatment

Remove any clothes or covering bedclothes.

Ensure a good supply of cool, fresh air.

Position pillows or soft padding around the child so that even violent movement will not result in injury.

Sponge the child with tepid water to help cooling.

Start from head and work down.

Keep the airway open.

FITS (CONVULSIONS) IN YOUNG CHILDREN

Treatment

Call for an ambulance if necessary.

Reassure the child and parents.

STROKE

A rapidly developing loss of brain function due to an interruption in the blood supply to all or part of the brain.

STROKE

STROKE

Recognition

Altered level of consciousness.

Slurred or garbled speech.

Loss of movement and feeling, usually on one side of the body.

Severe headache.

Difficulty in swallowing.

Flushed face.

Sometimes seizures.

STROKE

Recognition

Pupils may be different sizes.

Possibly head & eyes turned to one side.

Weakness.

STROKE

Treatment

Seek medical aid urgently.

Reassure the casualty. He or she may be able to

understand you, even unable to communicate.

If casualty is conscious, support the head and shoulders on pillows, loosen tight clothing, maintain body temperature and wipe away secretions from the mouth.

Ensure that the airway is clear and open.

DIABETES

A metabolic disorder characterized by hyperglycemia and other signs, as distinct from a single illness or condition.

Causes

Insufficient or too much insulin.

Insufficient glucose in a person who takes insulin.

Unaccustomed exercise.

A missed meal.

Infection in a known diabetic

DIABETES

Recognition

Dizziness.

Weakness, trembling or shaking.

Hunger.

Numbness around the lips and fingers.

Paleness.

Profuse sweating.

Rapid pulse.

Mental confusion.

DIABETES

Recognition

Excessive thirst.

Frequent need to urinate.

Hot, dry skin.

Smell of acetone on breath (like nail polish remover).

Drowsiness.

Unconsciousness.

DIABETES

Treatment

If casualty is unconscious:

Give nothing by mouth.

Seek medical aid urgently.

DIABETES

Treatment

If casualty is conscious:

Give sugar or drink liberally sweetened with sugar.

Continue giving sugar every 15 minutes until medical aid arrives or the casualty recovers.

Loosen tight clothing.

Seek medical aid.

Allow casualty to self-administer insulin. DO NOT administer for the casualty.