Treatment of Specific Unconsciousness

Treatment of Specific Unconsciousness: Unconsciousness can arise from various causes, each requiring a specific approach to treatment. In this comprehensive guide, we will explore the treatment of specific types of unconsciousness, including fainting (syncope), apoplexy or stroke, uraemic coma, eclampsia, heat stroke, diabetic coma, and insulin coma.

An unconscious patient

Fainting (Syncope):

   Fainting occurs when there is insufficient blood supply to the brain due to the weakened action of the heart. Common causes include hemorrhage, shock, confinement in a hot and stuffy atmosphere, sudden severe pain, prolonged standing, emotional upset, physical exhaustion, and lack of fresh air.

  

Signs and Symptoms of faints (syncope)

1. The patient feels dizzy, weak, shaky, and unsteady.

2. The face becomes pale, and the lips turn white.

3. Rapid and feeble pulse with shallow respiration.

4. Cold and clammy skin with perspiration.

5. Heaviness in the limbs.

6. Unconsciousness.

   

Treatment of Faint ( Syncope)

1. Have the patient sit down and lower their head between their knees to improve blood supply to the brain.

2. Ensure good ventilation by opening windows if indoors.

3. If the patient has fallen, loosen tight clothing and keep them flat.

4. In an unconscious state, place them in a prone position, undo tight clothing, and maintain good airflow.

5. Clear saliva from the mouth and ensure the tongue is forward.

6. Dash cold water on the face and chest, and rub the face vigorously.

7. Offer a stimulant like coffee or hot tea in small sips upon recovery.

8. Keep the patient warm if they feel cold.

9. Advise them to see a doctor if necessary.

10. If consciousness does not return promptly, seek medical aid.

Apoplexy or Stroke (Cerebrovascular Accident – CVA):

   Apoplexy, or stroke, is the sudden occurrence of unconsciousness in elderly individuals due to the hardening of arterial walls, leading to artery rupture or blood clot formation in cerebral blood vessels.

Signs and Symptoms of Apoplexy or stroke

1. May be preceded by prodromal symptoms.

2. Unconsciousness.

3. Flushed face and elevated temperature.

4. Slow and bounding pulse.

5. Snore-like respiration.

6. Paralysis on one side of the body.

7. Incontinence of urine and convulsions may occur.

Treatment of Apoplexy or stroke

1. Handle the patient with care to avoid mishandling.

2. Slightly raise the head and shoulders using pillows.

3. Turn the head towards the affected side.

4. Remove false teeth (dentures) and preserve them.

5. Keep the patient warm with blankets.

6. Maintain masterly inactivity; additional treatment may do more harm than good.

7. Arrange for transportation to the hospital.

Uraemic Coma (Uraemia):

   Uraemic coma is a complication of kidney disease caused by the accumulation of toxic substances, primarily urea, in the bloodstream.

 Signs and Symptom of Uraemic Coma

   – Gradual drowsiness leading to deep sleep.

   – Distressed respiration.

   – Recurrent fits, especially in elderly individuals.

   Treatment of Uraemic Coma

   – Seek medical aid immediately.

   – Keep the patient warm using blankets.

   – Nurse them in a darkened room.

Eclampsia:

Eclampsia is a type of unconsciousness occurring in pregnant women due to various factors, including albumin in urine, edema of the feet, and elevated blood pressure.

Treatment of Eclampsia

   – Follow first aid treatment for fits.

   – Transport the patient to the hospital for medical treatment.

Heat Stroke:

   Heat stroke can occur in hot climates or due to prolonged exposure to a hot environment, leading to overheating of the body.

Signs and Symptoms of heat stroke

   – Severe headache, nausea, giddiness, and weakness.

   – Hot and dry skin with a flushed face.

   – Rapid and feeble pulse.

   – Elevated body temperature.

   – Unconsciousness.

   

Treatment of Heat stroke

   – Remove the patient to a cool and shady area.

   – Strip the patient and keep them lying on their back with raised head and shoulders.

   – Apply cold compresses to the head and bathe the face with ice-cold water.

   – If unconscious and not breathing, perform artificial respiration.

   – Monitor the patient’s temperature.

   – Once the patient recovers, provide plenty of fluids.

Diabetes:

   Diabetes can lead to two types of coma: diabetic coma and insulin coma.

   Diabetic Coma:

   – Caused by excessive glucose in the blood with the presence of ketone bodies.

   – Gradual onset with symptoms like headache, restlessness, drowsiness, and thirst.

   – Deep, prolonged respiration, dry skin, and low blood pressure.

   – Unconsciousness.

   

Treatment of Diabetic Coma

   – Seek medical aid immediately.

   – Keep the patient warm and provide fluids without sugar or starch.

   

Insulin Coma:

   – Occurs due to missed meals, delayed meals, insulin overdose, or excessive exercise.

   – Sudden onset with weakness, confusion, and hunger.

   – Profuse sweating, normal blood pressure, and unconsciousness may follow

Treatment of Insulin Coma

   – Offer two lumps of sugar with water before unconsciousness sets in.

   – Encourage the patient to lie down and rest.

   – Test for the ability to swallow if unconsciousness occurs and provide sugar water if possible.

   – Seek medical assistance.

In all cases, prompt medical attention is crucial for the best possible outcome. It’s essential to keep the patient comfortable, maintain their airway, and provide necessary first aid while waiting for professional help.