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Unconsciousness (General)

Bryan Applications, U

If a person is found unconscious, or becomes so, he should be placed on his back, with the head to one side and slightly raised or not according as the face is flushed or pale. The clothing about the neck and chest should be loosened. The nature of the first-aid to be rendered further will depend on the circumstances in each case but a doctor should be summoned at once or as soon as a messenger is available.

The state of consciousness may be tested by opening the eyelids and touching the white of the eye. If the patient is at all conscious he will wince and make some attempt to close the eye. The causes of unconsciousness may be summarized briefly as follows.

(1) Death; there is no evidence of the beating of the heart, or of breath.
(2) Fainting or syncope; the condition resembles death, but there is quick recovery from simple fainting.
(3) Asphyxia; the face shows some lividity and the circumstances suggest the nature of the condition, as when a body has been taken from the water or from a gas-filled room, etc.
(4) Apoplexy; the breathing is stertorous and relative weakness may be discernable on one side of the body.
(5) Epilepsy; there may be signs of the patient’s having had a fit, such as marks on the ground or foam and blood on the lips.
(6) Heatstroke; the atmospheric temperature will be suggestive and the skin will feel burning hot; this will also be found when the unconsciousness is due to excess of fever.
(7) Poisoning by narcotics, such as alcohol opium, etc.
(8) Injuries to the head; there may be concussion, in which consciousness is not often completely lost, or compression of the brain by fragments of bone or by blood clot.
(9) Shock or collapse; there may be evidence of injury or of internal bleeding, which causes extreme pallor and a very rapid, thready pulse.
(10) Poisoning in diabetes or uremic poisoning from kidney disease; such conditions could only be recognized by an expert, as also unconsciousness due to meningitis or other diseases of the brain.
(11) Cold; in cold countries this is always a possible cause.
(12) Shock from lightning or electricity; the circumstances would be suggestive.
(13) Hysteria, including the death-like condition known as trance.

Possible errors in diagnosis:

It is necessary to guard against certain possible errors when proposing to identify any of those causes in a particular instance. In the first place, it should not be too readily assumed that a person is dead, as other conditions simulate death very closely. In the second place, a smell of alcohol from the patient should be ignored unless the possibility of some other cause of unconsciousness is definitely excluded. In the third place, a scalp wound does not necessarily mean that unconsciousness is due to a brain injury, as a person who becomes suddenly unconscious may strike his head falling.

As regards a number of the causes enumerated above, a clue will probably be furnished by the circumstances in which the patient is found. A bottle or the wrapping of a package in the vicinity of the person might put one on the track of poison. If an apoplectic seizure or an epileptic or hysterical convulsion is actually witnessed, the diagnosis of the subsequent unconsciousness will present little difficulty. A hysterical convulsion will often be preceded by emotional manifestations.

No attempt should be made to give an unconscious person alcohol, and this should be withheld even if the patient recovers sufficiently to be able to swallow, unless possibly after a simple faint.

Not even water should be given until the patient can swallow, and his ability to do so should be first tested by giving a few drops at a time. If breathing ceases artificial respiration should be carried out, but the mouth should first be opened to insure that the throat is clear. If the patient begins to vomit the head should be turned well to one side and the opposite shoulder should be raised. Warmth should be maintained when necessary by extra coverings and by hot-water bottles at the feet.

An examination should be made to insure that no bone is broken, and if there is any such thing the patient should not be moved until the fracture is properly controlled by splints. An unconscious patient should be carried in a recumbent position and should be handled with great gentleness. If there has been bleeding from a wound the possibility of a recurrence should be bome in mind, and someone should therefore be watchful and ready to control it should it happen. See: Epilepsy.. Shock..

Application and treatment:

A person who is unconscious does not receive any sensory impressions and does not have any subjective experiences. It may be caused by a head blow, brain pressure from a clot, lack of blood supply to the brain, effects of drugs such as opium, ether, chloroform, alcohol, carbon monoxide gas, relating to the brain. A number of factors must be considered: pulse rate and strength, the difficulty may be in blood circulation, or pallor or blue-ness or a purple color should blood trouble. If pulse is between 76 & 90 and strong, there is no immediate danger of death from the failure of respiration.

Check to see if the skin is hot or cold and determine if there is presence of perspiration or not. Check the pupils of the eyes to see if they are equal or unequal, if they are dilated or contracted. Unequal size pupils are a symptom of brain injury, such as brain hemorrhage. Feel the skull to find a fracture or crushing injury or swelling.

In the presence of heat, sunstroke may be the cause of unconsciousness. Breath odor may indicate the presence of acidosis or too much alcohol or ether. If the body tends to accumulate acid, dizziness or light-headedness or reflex sensations may be coming to the brain from other places.

Place person flat on their back with head lowered. (When face is pale) If face is red – keep head raised. Apply negative polarity over the heart for 3 minutes.

If the person has fallen go over the entire body with positive polarity to heal bones and bring body into a normalized recovery situation. To aid recovery use 1/2 tsp. aromatic spirits of ammonia given in water or smelling salts may help.