ALL ABOUT UNCONSCIOUSNESS IN NURSING
ALL ABOUT UNCONSCIOUSNESS IN NURSING: An individual who is unconscious is incapable of responding to external stimuli and is ignorant of their surroundings. We will examine many facets of unconsciousness in this thorough guide, including its description, levels, phases, causes, how to examine an unconscious patient, and the general care needed for someone in this state.
 |
| An unsconscious patient |
Definition of Unconsciousness
When used in a medical context, the term “unconsciousness” describes a condition in which a person is unaware of their surroundings and unable to respond to outside stimuli. It frequently exhibits a lack of sensibility and awareness. The degree of this illness might vary, and it can have a variety of causes, from unimportant things to grave dangers.
Levels of Consciousness
1. Fully Conscious: In this state, the patient is fully aware of their environment and can interact and respond to stimuli appropriately.
2. Disorientation to Time and Space: Individuals in this level can answer basic questions about themselves, such as their name and address, but may not know their current location.
3. Responds to Simple Commands: At this level, the person cannot answer questions but can follow simple commands like “sit up,” “stand up,” or “lie down.”
4. Response to Painful Stimuli: In this stage, the individual does not respond to spoken words but reacts to painful stimuli, such as pricking with a pin or the administration of an injection.
5. Complete Unresponsiveness: At this level, the person is entirely unresponsive to both spoken words and painful stimuli.
Stages of Unconsciousness
1. Stupor: Stupor is sometimes used to describe a state of partial consciousness, which includes levels 1 to 4 of the consciousness scale.
2. Coma: Coma is a state of complete unconsciousness in which all reflexes are absent, and the individual does not respond to any external stimuli.
3. Coma Vigil: Coma vigil is a condition in which the person’s eyes are wide open, giving the impression that they are awake and alert. However, it is an indication of extreme exhaustion and prostration, not true consciousness.
Causes of Unconsciousness
1. Fainting (Syncope): Fainting occurs when there is insufficient blood supply to the brain due to the weak action of the heart. Pre-disposing factors for fainting include fatigue, fear, severe emotional distress, pain, anemia, and poor ventilation.
2. Cerebral Anoxia: Cerebral anoxia refers to a lack of oxygen supply to the brain tissue. Fainting is a common example of this condition.
3. Asphyxia: Asphyxia, resulting from a lack of oxygen (O2) and the accumulation of carbon dioxide (CO2), can lead to unconsciousness.
4. Brain Injury: Traumatic events like a fractured skull, concussion, or brain compression can cause unconsciousness.
5. Brain Tumors: The presence of brain tumors can disrupt normal brain function and result in unconsciousness.
6. Apoplexy (Cerebrovascular Accident): Apoplexy encompasses conditions such as cerebral hemorrhage, cerebral thrombosis, and cerebral embolism, all of which can lead to unconsciousness.
7. Epilepsy: Epilepsy, a neurological disorder characterized by sudden and uncontrolled seizures, can cause episodes of unconsciousness known as fits.
8. Electric Shock: Severe electric shock can lead to unconsciousness due to the impact on the nervous system.
9. Diabetic and Insulin Coma: Diabetic coma can occur when blood sugar levels become dangerously high or low, leading to unconsciousness.
10. Uraemia: Uraemia refers to the accumulation of urea in the blood, often seen in advanced kidney disease, which can result in unconsciousness.
11. Eclampsia: Eclampsia is a condition that occurs during pregnancy and is characterized by seizures, protein in the urine, edema, and high blood pressure, leading to unconsciousness.
12. Poisoning: Unconsciousness can be a consequence of poisoning, whether by alcohol, poisonous gases, or drugs such as morphine, opium, barbiturates, and other hypnotics.
Examination of an Unconscious Patient
When encountering an unconscious patient, it is crucial to conduct a systematic examination to assess their condition and provide appropriate care. Here are key steps to follow:
1. Determine Onset: Find out whether the unconsciousness occurred suddenly or gradually, as this information can be vital for diagnosis.
2. Assess Level of Unconsciousness: Determine if the patient is partially conscious or completely unresponsive, following the levels of consciousness described earlier.
3. Check Pulse: Evaluate the patient’s pulse, noting its strength, rate, and regularity. Assess the apex beat of the heart, typically located 3 inches left to the sternum, in the mid-clavicular line, between the 5th and 6th intercostal space.
4. Observe Breathing: Carefully observe the chest and abdomen for signs of breathing, noting the movements of the respiratory muscles.
5. Examine the Eyes: Test the responsiveness of the patient’s eyes by touching the eyeball with a light source. In a state of consciousness, the patient should blink. Enlarged pupils may indicate specific conditions like Belladonna poisoning, suffocation, shock, or alcohol poisoning.
6. Gather Information: Attempt to gather information about the cause of unconsciousness from any available sources, including the circumstances, first-aid worker’s knowledge, or information from relatives or friends.
7. Document Findings: Make note of important factors, including the patient’s position, facial color (pallor, cyanosis, or flushed), presence of wounds, signs of hemorrhage, any specific odors on the patient’s breath, presence of convulsive movements, pulse rate, and characteristics of respirations.
General Care of the Unconscious Patient
Providing appropriate care for an unconscious patient is crucial to their well-being. Here are general care guidelines:
1. Positioning: If there are no specific injuries and the patient has cold, clammy skin and a pale face, place them in the prone position with the head turned to the side. For patients with a flushed face, lay them on their back with the head and shoulders slightly elevated on one pillow.
2. Airway Maintenance: Clear any saliva from the patient’s mouth and ensure that the tongue is positioned forward to prevent airway obstruction.
3. Clothing Adjustment: Loosen and undo tight clothing around the neck, chest, and waist to facilitate proper breathing and circulation.
4. Adequate Ventilation: Ensure a sufficient supply of fresh air around the patient. If indoors, open windows, and if outdoors, keep onlookers at a distance.
5. Artificial Respiration: If the patient’s breathing has ceased, initiate artificial respiration, such as mouth-to-mouth resuscitation, following appropriate guidelines.
6. Nothing by Mouth: Do not give any food or fluids by mouth to an unconscious patient, as they may be at risk of choking.
7. Temperature Regulation: Keep the patient reasonably warm by placing a coat or rug under and over them, as unconscious patients can be sensitive to temperature changes.
8. Check for Injuries: Examine the patient for any signs of hemorrhage or injuries. Address visible injuries or fractures promptly.
9. Identify the Cause: Attempt to determine the cause of unconsciousness by gathering information from accompanying relatives if available.
10. Seek Medical Assistance: Contact a healthcare professional or arrange for immediate transportation to a hospital to ensure appropriate diagnosis and treatment.
Unconsciousness is a complex medical condition with various levels, stages, and potential causes. When encountering an unconscious individual, it is crucial to conduct a thorough examination and provide appropriate care to ensure their well-being. Prompt recognition of the cause of unconsciousness and timely medical intervention can be life-saving. Always seek professional medical assistance when dealing with unconscious patients, as they may require specialized treatment and care based on the underlying cause of their condition.
Comments
Post a Comment