csc

1. UNCONSCIOUSNESS

2. At the end of the unit the student will be able
to:
 Identify the causes of unconsciousness;
 Identify the signs and symptoms of
unconsciousness;
 Describe the principles of management;
OBJECTIVES

3.  State the causes of asphyxia;
 Describe the appropriate first aid
management of the individual who is
asphyxiated;
 Identify the common types of fits which may
occur in adults and children;
 Explain the first aid management of the
patient who is having a fit;
OBJECTIVES

4.  State the causes and signs of
fainting;
 Initiate effective first aid to
casualties with fainting,
poisoning and drowning.
Objectives

5. CPR Videos

6. Unconsciousness
Is a state of unrousable,
unresponsiveness, where the victim
is unaware of their surroundings
and no purposeful response can be
obtained.
Unconsciousness occurs when a
person is suddenly unable to
respond to stimuli and appears to be
asleep. A person may be
unconscious for a few seconds (as
is the case with fainting) or for
longer periods of time (Kahn,
2019).
Unconsciousness -
Definition

7. Cessation of breathing due to
failure of the lungs to function
effectively. Interruption of
pulmonary gas exchange for > 5
min may irreversibly damage vital
organs, especially the brain.
Cardiac arrest almost always
follows unless respiratory
function is rapidly restored.
Respiratory Arrest

8. Cardiac arrest is the abrupt
loss of heart function in a
person who may or may
not have been diagnosed
with heart disease.
American Heart Association
2017
Cardiac Arrest

9. Cardiopulmonary resuscitation (CPR) consists of the use of
chest compressions and artificial ventilation to maintain
circulatory flow and oxygenation during cardiac arrest.
A life-saving emergency procedure that involves breathing for
the victim and applying external chest compression to make
the heart pump.
Resuscitation

10. CPR should be performed immediately on any
person who has become unconscious and is found
to be pulse-less.
The only absolute contraindication to CPR is a do-
not-resuscitate (DNR) order or other advanced
directive indicating a person’s desire to not be
resuscitated in the event of cardiac arrest.
Cardiopulmonary Resuscitation-
Indications

11. The causes of unconsciousness can be classified into four broad
groups:
1. Low oxygen levels to the brain,
2. Heart, and circulation problems (e.g., fainting, abnormal heart
rhythms)
3. metabolic problems (e.g., overdose, intoxication, low blood sugar)
4. brain problems (e.g., head injury, stroke, tumour, epilepsy).
UNCONSCIOUSNESS

12. Unresponsive
Tachycardia,
bradycardia or no pulse
Tachypnoea, bradypnea
or no respiration
Signs and
symptoms of
Unconsciousness

13. Principles of Management
Treat the Cause
Restore acid-base balance and electrolyte
balance
• Adjust body temperature
• Consider specific antidotes (naloxone,
flumazenil)
• Control agitation
• Ensure oxygenation
Ensure
• Maintain circulation
Maintain
• Control glucose
Control
• Lower intracranial pressure
Lower
• Stop seizures
Stop

14. First perform a primary survey.
The primary survey is a quick way to find
out how to treat any life threating
conditions a casualty may have in order
of priority. Use DRABC to do this:
Danger, Response, Airway, Breathing
and Circulation.
UNCONSCIOUSNESS

15. Only essential personnel should be allowed
in the room or on the scene.
EMS personnel and healthcare workers
should protect themselves and their
colleagues from unnecessary exposure to
confirmed or suspected COVID-19 infections,
according to the AHA.
April, 2020
UNCONSCIOUSNESS

16. The American Heart Association (AHA)
issued interim cardiopulmonary
resuscitation (CPR) guidelines that apply
during the COVID-19 pandemic.
The AHA recommended bystanders and lay
rescuers administer “hands only” CPR
without mouth-to-mouth ventilation to limit
exposures to the SARS-CoV-2 virus that
causes COVID-19.
April, 2020
UNCONSCIOUSNESS

17. Those administering CPR as first aid also should consider
covering their own and the cardiac arrest victim’s nose and
mouth with a face mask or cloth to reduce the likelihood of
disease transmission. Rescuers should use an automated
external defibrillator (AED), if one is available, because
defibrillation is not expected to generate aerosol particles.
Both EMS personnel and healthcare workers should don
personal protective equipment (PPE) to guard against contact
with both airborne and droplet particles .
April, 2020
UNCONSCIOUSNESS

18. If the casualty is unresponsive but
breathing, put them in the recovery
position.
Kneel by the casualty and straighten
their legs.
If they are wearing glasses, or have
any bulky items in their pockets,
remove them.
Do not search their pockets for small
items.
UNCONSCIOUSNESS

19. Unconsciousness videos

21. Check the casualty’s airway to make
sure there is no obstruction. Do not
put your face close to the casualty.
Check again to see if the casualty is
breathing, coughing, or moving.
These are signs of positive circulation.
If these signs are absent, perform
CPR ( in the order of CAB) until
emergency personnel arrive.
UNCONSCIOUSNESS

22. Due to the COVID-19
outbreak, use a bag valve
mask or mouth barrier
before giving rescue
breaths.
Compressions should be given
at a rate of at least 100/120
min with a depth of at least 2
inches (5cm) no more than 2.4
for adults.
UNCONSCIOUSNES
S

23. Continue CPR until:
 emergency help arrives and takes
over
 the person starts showing signs of life
and starts to breathe normally
 you are too exhausted to continue(if
there is a helper, you can change over
every one-to-two minutes, with
minimal interruptions to chest
compressions)
 a (AED) defibrillator is ready to be
used.
UNCONSCIOUSNESS

24. Unconsciousness
• If the casualty shows signs of
becoming responsive such as
coughing, opening eyes,
speaking, and starts to breathe
normally, put them in
the recovery position.
• Monitor their level of response
and prepare to give CPR again
if necessary.

25. Child 1
year to
Puberty
• When a child/infant has a pulse
of more than 60/minute but is
not breathing or is gasping, the
rescuer should give breaths
without chest compressions.
• When an unresponsive
child/infant has a pulse of less
than 60/minute and is not
breathing with signs of poor
perfusion.
• Despite oxygenation and
ventilation with a bag or mask,
the rescuer should perform
both compressions and
breaths.

26.  After you have performed a primary
survey, if you find that the child is
unresponsive and not breathing you
should call for help. If you are on
your own, activate the emergency
response system via mobile device if
appropriate.
 If someone else is present, ask them
to call.
Child CPR

27. After 30 compressions (at a
depth of approximately 2
inches or 5cm for children)
open the airway and give
two breaths.
Keep alternating 30
compressions with two
breaths (30:2) until:
emergency help arrives and
takes over
the child starts showing
signs of life and starts to
breathe normally
a defibrillator is ready to be
used.
CHILD
CPR

28. Giving rescue breaths.
Open their airway. To do this,
place one hand on their forehead
to tilt their head back and use two
fingers from the other hand to
gently lift the chin.
Take the hand from the forehead
and pinch the soft part of the nose
closed, allowing the mouth to fall
open.
CHILD
CPR

29. Doing rescue breaths may increase
the risk of transmitting the COVID-19
virus, either to the rescuer or the
child. This may be mitigated by
placing a face shield or pocket mask
over the child’s mouth.
It is vital that you perform rescue
breaths as cardiac arrest in a child
is likely caused by a respiratory
problem.
CHILD
CPR

30. Unconscio
us Child –
opening
airway

31. Rescue
Breaths

32.  If the helper returns with a
defibrillator, ask them to switch it
on and follow the voice prompts
while you continue with CPR.
 If the child shows signs of
becoming responsive such as
coughing, opening eyes, speaking,
and starts to breathe normally, put
them in the recovery position.
Monitor their level of response and
prepare to give CPR again if
necessary.
 If you have used a defibrillator,
leave it attached
CHILD
CPR

33.  After you have performed a primary
survey, if you find that the baby is
unresponsive and not breathing, you
should ask a helper to call for
emergency help while you start CPR.
 If you are on your own, you need to
give one minute of CPR before
calling on a speakerphone.
 Do not leave the baby to make the
call
BABY- under
1 year

34.  You will then need to give 30
pumps. Put two fingers in the
centre of the baby’s chest and push
down approximately 1 ½ or 1.5
inches (4cm) a third of the depth of
the chest. Release the pressure
allowing the chest to come back up.
 Repeat this 30 times at a rate of 100
to 120 pumps per minute.
BABY -
under 1
year

35.  Give rescue breaths.
Place them on a firm
surface and open their
airway. To do this, place
one hand on their
forehead and very
gently tilt their head
back. With your other
hand, use your
fingertip and gently lift
the chin.
BABY -
under 1
year

36.  If the chest does not rise, check if
the airway is open.
 Doing rescue breaths may increase
the risk of transmitting the COVID-
19 virus, either to the rescuer or the
baby. This may be mitigated by
placing a face shield or pocket
mask over the baby’s mouth.
 It is vital that you perform rescue
breaths as cardiac arrest in a
baby is likely caused by a
respiratory problem.
BABY -
under 1
year

37.  Keep alternating (30:2) until:
 emergency help arrives and takes
over
 the baby starts showing signs of life
and starts to breathe normally
BABY -under 1
year

38. If the baby shows signs of becoming responsive, such as,
coughing, opening their eyes, making a noise, or starts to
breathe normally, put them in the recovery position.
Monitor their level of response and prepare to give CPR again
if necessary.
BABY -under 1 year

39. For a small child, use a one-handed CPR
technique
• Place the heel of one hand in the center of the child’s
chest
For a baby, place both thumbs (side-by-
side) on the center of the baby’s chest,
just below the nipple line
• Use the other fingers to encircle the baby’s chest
toward the back, providing support
Alternatively, for a baby, use the two-
finger technique
• Use two fingers placed parallel to the chest in the
center of the chest
Hand Placement
in Children

40. Hand placement for CPR in children

41. What is
happening
?

42. Syncope
/Fainting

43. Syncope is a temporary loss of consciousness usually related
to insufficient blood flow to the brain.
It most often occurs when blood pressure is too
low (hypotension) and the heart does not pump enough
oxygen to the brain. It can be benign or a symptom of an
underlying medical condition.
AHA, 2020
FAINTING/SYNCOPE

44. Causes include:
 Heart problems such as irregular heart beats
 Seizures
 Low blood sugar (hypoglycaemia)
 Anaemia ( deficiency in healthy oxygen carrying cells)
 Problems with how the nervous system regulates blood pressure
 Overheating, dehydration, heavy sweating, exhaustion or the
pooling of blood in the legs due to sudden changes in body position.
 Pregnancy
FAINTING/SYNCOPE

45. Aims
To improve blood flow to
the brain.
To reassure and make the
casualty comfortable.
Syncope /
Fainting

46. Make a rapid examination
of the patient to assess
responsiveness and the
extent of the injury;
Check breathing,
circulation and look for
serious bleeding;
Fainting

47. Before fainting, the casualty may have complained of:
weakness
nausea
dizziness
confusion
sudden trouble hearing
tunnel vision or blurred vision
perspiration/ sweating
Syncope /
Fainting

48. Signs and symptoms
flushed or pale color
feeling hot
trembling or shaking
Syncope /
Fainting

49. Signs and symptoms
Eye shaking (nystagmus)
headache
shortness of breath
tachycardia
Syncope /
Fainting

50.  Ask them to lie down.
 Check for other injuries.
 If the casualty falls down, look for head injuries and any other
wounds.
 Treat as appropriate
Fainting

51. See that the patient is put in the most comfortable position
possible and loosen tight clothing so that he can breathe
easily;
Do not remove more clothing than is necessary and, when
you do, remove it gently.
Fainting

52.  Kneel down next to the casualty
and raise their legs, supporting their
ankles on your shoulders to help
blood flow back to the brain.
 Elevate the feet above the level of
the heart (about 12 inches).
 Make sure that the casualty gets
plenty of fresh air.
 Ask other people to move away and
if you are inside, ask someone to
open a window.
Fainting

53. If the casualty begins to show signs of
recovery
Reassure the casualty and help them to sit
up slowly.
If they begin to feel faint again, lie them
down again.
If they stay unresponsive, open the airway,
check their breathing and prepare to treat
someone who is unresponsive.
Fainting

54. Asphyxia or suffocation is a condition of
the body that occurs from
severely inadequate oxygen supply or
excessive carbon dioxide to the body
(Crystal, 2013; Ibrar, 2014).
There are many circumstances that can
induce asphyxia, all of which are
characterized by an inability of an
individual to acquire sufficient oxygen
through breathing for an extended
period. Asphyxia can cause coma or
death.
ASPHYXIA

55. Asphyxia

56. Choking
Seizures
Sleep apnea
Near drowning / drowning
Compression of chest
 Gas poisoning
 Electrical accidents
 Strangulation
 Respiratory
problems
Asphyxia
Causes

57. Complications from Asphyxia
 Coma
 Brain death
 Death
(Permanent brain damage begins after
only 4 minutes without oxygen, and
death can occur as soon as 4 to 6
minutes later)
Asphyxia

58. Signs and Symptoms
 Difficulty and/ or noisy, or
cessation in breathing
 Rapid pulse
 Hypertension
 Cyanosis
 Swollen veins on the head and
neck
 Convulsions
 Paralysis
 gradual loss consciousness
Asphyxia

59. Choking occurs when a
foreign body (e.g., a
mouthful of food) partially or
completely blocks a person's
airway making breathing
difficult.
Choking is a medical
emergency. If the object
causing the blockage cannot
be easily removed call 119
immediately.
Choking

60. • eating or drinking too
quickly
• swallowing food before
it has been sufficiently
chewed
• swallowing small bones
or objects
• inhaling small objects
Causes of
choking

61. Choking
Mild airway obstruction Rescuer actions
 Good air exchange
 Can cough forcefully
 May wheeze between coughs
Once there is good air exchange
encourage the casualty to cough
Do not interfere with the victims
attempts to relieve the obstruction.
Stay with the victim and monitor
the condition
If mild airway obstruction
continues or progresses to signs of
severe airway obstruction activate
the emergency response system

62. Choking
Severe airway obstruction Rescuer Actions
 Clutching the throat with
thumb and fingers, making the
universal choking sign
 Unable to speak or cry
 Poor or no air exchange
 Weak, ineffective cough or no
cough, gagging
 High pitched noise while
inhaling or no noise
 Increased respiratory difficulty
 Possible cyanosis-blue/ashen
lips or skin, red/ashen or puffy
face
 If the casualty or child, ask “Are
you choking?”, If they nod yes
and cannot talk, severe airway
obstruction is present
 Take steps immediately to relieve
the obstruction
 If the casualty becomes
unresponsive, start CPR
 If you are not alone, send
someone to activate the
emergency response system. If
you are alone and must leave to
activate the emergency response,
provide 2 minutes of CPR before
leaving

63. Choking
First Aid Management in Adults
Assessment
 Look for the universal sign of choking
• Encourage coughing

64. If you think
someone is choking,
ask them ‘Are you
choking?’
01
If they can breathe,
speak or cough then
they might be able
to clear their own
throat.
02
If they cannot
breathe, cough, or
make any noise,
then they need your
help straight away.
03
Choking

65. If coughing fails to work,
give five sharp back blows.
To do this, help the
casualty to lean forwards,
supporting their upper
body with one hand.
With the heel of your
other hand give them five
sharp back blows between
their shoulder blades.
After each back blow,
check to see if there is
anything in the mouth
Choking

66. Back
Blows

67. Use abdominal thrusts to relieve choking in
a responsive adult or child.
Do not use abdominal thrusts to relieve
choking in an infant.
If the victim is pregnant or obese do
chest thrusts instead of abdominal
thrusts.
Choking

68. Heimlich manoeuvre/Abdominal Thrusts

69. Heimlich manoeuvre &
Chest thrust
conscious pregnant
obese

70. To relieve choking in an infant who is
responsive, kneel or sit with the infant
in your lap. Support the infant’s jaw and
head.
Lay the infant face down along your
forearm and thigh, with the head
slightly lower than the chest, resting on
your forearm. Avoid compressing the
soft tissues of the infant’s throat.
Choking Infant

71.  Deliver 5 back blows between the infant’s shoulder blades with
the heel of your hand with enough force to dislodge the foreign
object.
 While supporting the infant’s head and neck, turn the infant onto
the back, keeping the head lower than the trunk and deliver 5
quick downward chest thrusts at a rate of 1 per second with
enough force to dislodge the foreign body.
Choking Infant

72.  First Aid Management in infant
 Give five back blows and check infants' mouth
 Give five chest thrusts
 Repeat the sequence up to five times until the object is
dislodged, or the infant becomes unresponsive
Choking

73.  Unresponsive infant- call/shout for emergency help
 Place the infant on a firm, flat surface
 Begin CPR starting with compressions (with one extra step) Each time the
airway is opened look for the object, if you see an object and can easily
remove it, do so
 Do not check for a pulse before starting CPR
 After 2 minutes of CPR activate the emergency response system if no one
has done so.
Choking

74. Choking

75. First Aid Management in child 1yr to puberty
 Encourage cough
 Give:
five back blows
five abdominal thrusts
call emergency help
Choking

76. Finger sweep is only done on
unconscious casualties
Using a hooking action to dislodge
the foreign body and maneuver it
into the mouth for removal.
Avoid forcing the object deeper into
the throat.
Choking

77. Finger sweep

78. If obstruction does not
clear after 3 cycles, call for
help
Continue back blows and
abdominal thrusts until
help arrives
Medical attention IS A
MUST if abdominal thrusts
are done.
Choking

79. Google Images
American Heart association (2020) Basic Life Support Provider
Manual
St. John’s Ambulance, St. Andrew’s First Aid and British Red
Cross (2016). First Aid Manual. (10th
Ed.). Great Britain: Dorling
Kindersley Ltd.
Retrieved from:
https://www.cdc.gov/epilepsy/about/first-aid.htm
Retrieved from:
https://emedicine.medscape.com/article/772753-overvie
References

80. Retrieved from: http://firstaidandcprcourses.ca/asphyxia-cause
s-signs-and-symptoms-complications-and-first-aid-manageme
nt/
Retrieved
from:https://www.ncbi.nlm.nih.gov/books/NBK538529/
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gic-disorders/seizure-disorders/seizure-disorders
Retrieved from:
https://www.hcpro.com/SAF-333702-874/American-Heart-Assoc
iation-Issues-COVID19-CPR-Guidelines.html
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https://www.webmd.com/brain/understanding-fainting-basics
#1
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https://www.redcross.org/take-a-class/cpr/performing-cpr/chil
d-baby-cpr
References