We've all seen people surrounding another person. After getting closer and asking a bystander what happened, the reply is, "a man" or "a woman collapsed."
Unconsciousness is a significant problem and deserves your best attention and that of a physician. An altered mental status - unconscious or not - is a very frightening experience for both the victim and bystanders. Be assured, you will encounter sometime during your life an unconscious person. So knowing a little about it and what to do can greatly alleviate any fears you might have.
Causes of unconsciousness
Unconsciousness can be caused by diseases, injuries, emotional reactions, environmental causes or injected or ingested agents.
- Diseases
- Diabetes mellitus. Diabetes mellitus, one of the world's most common diseases, which affects blood sugar, is one of the most common causes of weakness and dizziness. One of every 20 Americans will develop diabetes during his or her lifetime.
In the diabetic, unconsciousness may develop if too much insulin is taken without enough food so that the amount of glucose in the blood (blood sugar level) drops below a level needed for adequate brain functioning (known as insulin shock). If permanent brain damage is to be avoided, insulin shock must be treated immediately by giving glucose to offset the excessive insulin.
The opposite state - insufficient insulin, called diabetic coma or diabetic ketoacidosis - develops more slowly. With insufficient insulin, the amount of glucose in the blood rises and causes excess fluid and sugar loss from the kidneys. This results in dehydration and an accumulation of metabolic waste products.
- Arteriosclerosis. This can develop in any blood vessel. When the disease subsequently blocks the arteries supplying the heart muscle, a heart attack may follow. The lack of oxygen causes pain and abnormal heart rhythms. A loss of consciousness happens if the arrhythmia results in a lack of oxygen to the brain.
When arterioslerosis damages arteries in the brain, a blood clot may develop that obstructs blood flow to the brain and causes a brain attack or a stroke.
- Electrolyte disorders. Leading the list of possible culprits is dehydration, which can cause massive loss of fluid and electrolyte imbalance. Two of the most common causes are vomiting and diarrhea, both of which result in loss of fluid, sodium, potassium and chloride. Other causes can include not drinking enough fluids or having increased urinary output.
- Injuries
Many injuries cause unconsciousness, especially those resulting in blood flow loss to the brain and heart.
- Respiratory system injuries. Injuries in the chest wall cause severe pain, which restricts breathing. Blood in the chest cavity or air in the chest cavity from a perforated chest wall or lung reduces the lungs' capacity to transport oxygen. Spinal cord injuries may result in paralysis of some or all of the muscles of breathing, which leads to unconsciousness.
- Head injuries. The most common causes of unconsciousness are concussions, contusions or hematomas.
- Emotional reactions
Fainting is an emotional reaction resulting in a temporary but sudden dilation of blood vessels. Momentarily, inadequate blood flow is unavailable to the brain.
- Environmental causes
- Extreme heat or cold. Unconsciousness due to extremes of heat (heatstroke) or cold (hypothermia) is easily recognized by the circumstances and the victim's body temperature.
- Electrical shock. Cardiac arrest or stoppage can occur. A major problem is not only a situation involving a victim but the threats to a potential rescuer.
- Water emergencies. Drowning victims and those experiencing either air embolism (arterial blood flow obstruction by air bubbles) or decompression sickness (arterial blood flow obstruction by nitrogen bubbles) are examples.
- Injected or ingested agents
Injected or ingested substances, such as alcohol, drugs and plant and animal poisons, have a direct toxic effect on the brain. Some are very toxic in minute amounts.
One of the more interesting examples is the drinking of grapefruit juice while using the antihistimine Seldane. This combination can produce a serious type of irregular heart beat. About 125 deaths have been reported. The U.S. Food and Drug Administration has recommended that Seldane be removed from the market.
- First aid
All unconscious victims require emergency medical treatment, regardless of the specific cause of the unconsciousness. In general, a first-aider should:
1. Check to see if the airway is open by using the head-tilt/
neck-lift technique.
2. Check to see if the victim is breathing by looking for the victim's chest to rise and fall and to listen and feel for air movement.
3. Check to see if the victim has a pulse by feeling for the carotid pulse in the groove between the Adam's apple and neck muscle.
4. Depending upon if there is no breathing and/or pulse, give rescue breathing or cardiopulmonary resuscitation (CPR).
5. An unresponsive but breathing victim should be placed in the "recovery" position to avoid possible aspiration of vomit, mucus, etc. This means placing the victim on his or her left side with their right hand under their left cheek and the right leg bent to prevent the victim from rolling.
6. Seek immediate medical attention for the victim by calling 911 or the local emergency telephone number to activate the emergency medical service (EMS). Any victim of unconsciousness, with the exception of some types of fainting, should seek a medical evaluation.
7. Note any items that might serve as evidence regarding the cause of unconsciousness.