When someone appears to be unconscious or unresponsive, and they do not respond to verbal commands, follow these steps in this order:
- check their airway is open without signs of blockage, such as laboured breathing or high-pitched breath sounds
- look for signs they are breathing
- check for a pulse or heartbeat
- Call or have someone else call the emergency medical services, in case of following: Patient has no pulse or only a weak pulse, does not appear to be breathing, does not respond or regain consciousness within 1 minute, seems to be severely injured or is bleeding heavily
There are also some things to avoid when administering first aid:
- Do not leave an unconscious person unattended
- Do not put a cushion under an unconscious person’s head and do not try to get them to sit up.
- Do not splash an unconscious person with water or slap them.
- Do not try to get them to drink water or other liquids.
- If there is something visible at the back of the person’s throat or high in the throat that is blocking the airway, try to remove it by using one finger to sweep the mouth. Do not do a finger sweep or try to grab at anything lodged in the person’s throat if it is not visible. This may cause it to become lodged deeper.
- If they are not breathing and they have an object lodged in the throat, continue performing chest compressions and checking to see if the object has dislodged.
First aid steps
Before acting, it is essential to determine whether the unconscious person is breathing or not, as this will inform what to do next.
If the person is breathing
- If the person is still conscious but seems dazed, ask them basic questions, such as what their name and birthday is or what the date is today.
- Wrong answers or an inability to answer may mean they are experiencing a change in mental status. Share this information with emergency medical services.
- If it appears the person may have a spinal injury, leave them as they are. Take measures to keep their neck supported and still.
- If the person is breathing and it is unlikely they have a spinal injury, roll them into the recovery position on their side. Adjust the person’s legs, so their hips and knees form right angles. Tilt their head gently back to be sure their airway is open.
If the person is not breathing
- If an unconscious person is not breathing, it may be necessary to move them carefully onto their back, while protecting their neck, so that they can receive cardiopulmonary resuscitation (CPR).
- Call ambulance before administering CPR.
- Signs, such as moving, coughing, or breathing is good signs. If these signs are not there, continue giving CPR until the emergency assistance arrives.
If the person is bleeding
- If the unconscious person is bleeding heavily, locate the injury and place strong, direct pressure on the wounded area to slow the flow of blood.
- If possible, apply a tourniquet above the bleeding area to slow the bleeding until emergency services arrive. To apply a tourniquet, wrap a cord or bandage tightly around the affected limb.
How to perform CPR
Compressions: Restore blood circulation
- Put the person on his or her back on a firm surface.
- Kneel next to the person’s neck and shoulders.
- Place the heel of one hand over the center of the person’s chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
- Use your upper body weight (not just your arms) as you push straight down on (compress) the chest at least 2 inches (approximately 5 centimeters) but not greater than 2.4 inches (approximately 6 centimeters). Push hard at a rate of 100 to 120 compressions a minute.
- If you haven’t been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to opening the airway and rescue breathing.
Airway: Open the airway
- If you’re trained in CPR and you’ve performed 30 chest compressions, open the person’s airway using the head-tilt, chin-lift maneuver. Put your palm on the person’s forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.
Breathing: Breathe for the person
Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can’t be opened.
- With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-to-mouth breathing and cover the person’s mouth with yours, making a seal.
- Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn’t rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. Thirty chest compressions followed by two rescue breaths is considered one cycle. Be careful not to provide too many breaths or to breathe with too much force.
- Resume chest compressions to restore circulation.
- As soon as an automated external defibrillator (AED) is available, apply it and follow the prompts. Administer one shock, then resume CPR — starting with chest compressions — for two more minutes before administering a second shock. If you’re not trained to use an AED, a 911 or other emergency medical operator may be able to guide you in its use. If an AED isn’t available, go to step 5 below.
- Continue CPR until there are signs of movement or emergency medical personnel take over.
One must contact emergency services immediately in case of any of the signs like-loss of bladder or bowel control, having a seizure or fit, not breathing or no pulse.
These steps should be disseminated to the public at large for a better outcome for a patient who is unconscious.