Loss of consciousness: causes, first aid, symptoms of disease, treatment

Types of loss of consciousness

Loss of consciousness is classified as an abnormal condition that is characterized by loss of reflexes and disturbances in the functioning of the nervous system. Develops when there is a small amount of oxygen caused by problems with blood circulation. Quite often, against the background of this condition, a deterioration in the functioning of all existing reflexes develops. Loss of consciousness is characterized by the fact that a person falls and does not move (an exception may be an epileptic seizure or muscle twitching), there is no reaction to various irritating elements.

Fainting and loss of consciousness

The difference between these conditions is in the causes, provocateurs and consequences. Syncope is most often formed due to reversible disturbances in the supply of blood to cells, which are formed as a result of a sharp decrease in pressure.

Prolonged syncope, characterized by a prolonged lack of oxygen in the brain tissue, is based on severe organic disorders and provokes problems with vital functions.

First aid if a person loses consciousness or faints

Loss of consciousness is a condition in which a person lies motionless, does not respond to questions and does not perceive what is happening.

When you lose consciousness, the part of your brain responsible for conscious thought shuts down. At the same time, the parts of the brain that control reflexes, breathing and blood circulation processes (in particular, the medulla oblongata) can work.

Loss of consciousness occurs with: - a significant lack of oxygen in the blood (or lack of blood) - a concussion (impact of the brain on the skull) - severe pain or nervous shock

Loss of consciousness can be caused by: overwork, hypothermia, overheating, lack of oxygen in the air, severe pain, deep emotional shock, dehydration (for example, due to severe diarrhea, vomiting), head injury, hemorrhage, electric shock or poisoning.

Typically, loss of consciousness does not occur suddenly. Most often, the human body shows the first signs in the form of dizziness, nausea, ringing in the ears, severe weakness, blurred vision, cold sweat, as well as a feeling of emptiness in the head and numbness of the limbs. The person begins to turn pale, his pulse weakens, and his blood pressure decreases. After which the eyes close, muscle tone disappears and the person falls.

What to do if you lose consciousness?

1. If you see that a person is losing consciousness, try to prevent him from falling and hitting his head.

2. Eliminate the factor that led to loss of consciousness (if it is still active). For example, take the person out of a stuffy room or open a window, move a live wire away from him, etc.

3. Place the person on the floor. He shouldn't sit! To ensure oxygen access, unfasten the collar and loosen the belt. Do not put anything under his head, or better yet, lift his legs up a little. This is necessary in order to facilitate blood flow to the brain.

4. Try to bring him to consciousness with the help of external stimuli - patting his cheeks, cold water or ammonia. If there is no ammonia, bring a cotton swab soaked in vinegar.

5. If he does not regain consciousness, check for breathing and pulse with two fingers on the neck (carotid artery)

6. If there is no breathing or pulse, perform artificial respiration and cardiac massage

7. If there is breathing and a pulse, turn the person on his side. This is necessary so that in case of vomiting he does not choke.

8. Call an ambulance

There is no need to treat loss of consciousness as a protective reaction of the brain (like, let him lie unconscious and rest). When you lose consciousness, irreversible changes can occur in the brain tissue. Therefore, if possible, you need to quickly return the person to consciousness.

It often happens that after fainting a person becomes embarrassed because a lot of attention is being paid to him and refuses further help. You should insist that he not be left unaccompanied anytime soon because the fainting spell may reoccur.

First signs

The following are signs that precede syncope:

• causeless anxiety, weakness, incessant yawning, heavy breathing;
• pale skin, sweating;
• headaches that bring a pressing or squeezing sensation, noise in the ears (ringing in the ears may be present), dizziness, hearing problems, suffocation;
• adrenaline rush, accompanied by heat at the end of the fingers;
• darkening before the eyes;
• tonic convulsions;
• a sharp increase or decrease in pressure, heart rate increases;
• nausea, vomiting, sour taste in the mouth.

Fainting is characterized by the presence of the following manifestations:

• the muscles are relaxed and the body is motionless;
• breathing slows down;
• blood pressure decreases;
• in case of deep fainting, the occurrence of convulsions and incontinence cannot be excluded;
• Pupils dilate, in the presence of serious pathologies, there is no reaction to light.

Main pathologies

Syncope is caused by insufficient supply of ozone to the brain, which is usually caused by the presence of disturbances in the functioning of the body.

Vagal loss of consciousness

Most often they develop with spasms that narrow the nutrient vessels or with a decrease in pressure, and does not depend on severe pathologies of an organic nature. Some of the least dangerous causes of syncope include the following:

• stress (painful sensations or their expectations, the appearance of blood, an uncontrollable state of fear up to panic attacks, nervous overstrain);
• reflexes: coughing, sneezing, pain during urine excretion, penetration of a foreign object into the throat, problems with bowel movements, serious exercise;
• vegetative-vascular pathologies that develop during panic attacks.

After this condition, all functions are fully restored, but severe fatigue and panic attacks may be present.

Cardiogenic causes

The main factor causing syncope in 25% of cases is heart disease. After loss of consciousness occurs, it is immediately necessary to undergo a thorough diagnosis, since if this is not done, then a serious illness can be overlooked.

Most often, the factor that provokes insufficient oxygen supply to the brain and the formation of syncope in diseases of a cardiogenic nature is a decrease in the number of blood during cardiac output (blood pushed into the aorta during one contraction). As a rule, syncope is formed due to serious illnesses caused by disturbances in the heart rhythm (arrhythmia or tachycardia is detected, in which the heart rate is more than 160 beats per minute).

Loss of consciousness of arrhythmic type

This kind of syncope is caused by the presence of the following pathologies:

1. Paroxysmal tachycardia is a sharp increase in the number of myocardial contractions per minute (more than 150).
2. Ari – characterized by a high probability of cardiac arrest. It is quite difficult to identify such a pathology, since by the time the cardiogram is performed, the paroxysm has already disappeared, and such a false diagnosis as physiological fainting can be made. This does not reduce the likelihood of death.
3. Weakening of the sinus node (poor functioning of the central node that controls the rhythm of the heart).
4. Atrial fibrillation and gastric fibrillation.
5. SVC syndrome is characterized by a pathological path of impulse conduction in the myocardium.

With this kind of disease, rhythm problems arise and the saturation of brain cells with blood is interrupted.

Other reasons

Other causes of insufficient cardiac output include the following:

• problems with the functioning of the ventricles;
• a heart attack that provoked problems with muscle contraction;
• congenital or acquired defects of the heart structure;
• vascular thrombosis;
• atherosclerosis.

With prolonged weak functioning of the coronary vessels, ischemia is formed (cell death occurs). Atrophy of the active fibers of the heart is observed; they are replaced by connective tissue, which is characterized by increased density and is unable to contract. There is a decrease in the output volume, the brain cells do not have enough oxygen, which causes a loss of syncope.

What to do if you see an unconscious person

Confusion is the feeling that most people seem to experience when they see an unconscious person. At the same time, in reality it is quite easy to help: very simple and understandable algorithms have been developed for this. Of course, a person who has completed first aid courses can bring much more benefit, but everyone else, with the help of fairly simple manipulations, is able to naturally save the life of the victim. So, you see a person who lies and shows no signs of life. What to do?

The first rule that everyone forgets is to make sure you are safe. You will run towards a person across the sidewalk and collide with a cyclist. Or you will come across exposed wires near the victim. In general, make sure that you can provide help without harming yourself. If everything is fine, then first you need to understand whether this person really has problems: he can just sleep. To get his bearings, call him and shake his shoulder. Any ambulance worker will tell you that often people don’t do this, they immediately call an ambulance, and it goes to wake up sleeping homeless people or people in a state of intoxication. It seems that this is still not what such a service should do.

But now you shock the person - he does not answer. Then first of all you need to decide how serious it is. Perhaps it is a simple fainting, perhaps the person has died, perhaps his heart is beating incorrectly and he can still be saved. And in an amicable way, further actions should depend on whether the person is breathing or not. Many people immediately rush to check their pulse, but studies show that few people can do it well.

You need to check your breathing according to the following rules:

- turn the person onto his back; - support his chin, press on his forehead and thereby tilt his head back; - bend over and listen for 10 seconds to see if the person is breathing, while simultaneously watching to see if the chest rises.

If there is breathing, you need to put the person on his side and call an ambulance. This position will help him breathe: his tongue will not sink, and he will not be able to choke on vomit. In a situation where you have forgotten how to check breathing, and without this it is not clear whether a person is breathing or not, you can do the same.

How to properly turn an unconscious person onto his right side - Kneel next to him.
- Place his hand closest to you at a right angle to your body, palm up. — Throw the hand farthest from you over your head so that its palm touches the cheek closest to you. - Bend the leg farthest from you at the knee at a right angle. - Turn the person onto their side by pulling on the bent knee. At the same time, his hand farthest from you will protect his head from hitting the floor, and the closest one will not allow his body to roll more than necessary and lie face down. If there is definitely no breathing, then it means that the heart most likely is not beating, you need to call an ambulance and start resuscitation. If you have checked your breathing and hear some strange wheezing, then assume that it is not there. Ideally, you should also send someone to get an automated external defibrillator (AED) and begin chest compressions yourself. And there are several nuances here.

Firstly, if you do not know how to do chest compressions and are very afraid of causing harm by doing it incomprehensibly according to the dispatcher’s orders, then you can limit yourself to turning the person on his side.

Secondly, there are practically no AEDs in Russia (only in rare airports and companies), and the law that was supposed to promote their distribution is stuck in the State Duma.

Probably a lot of people are wondering right now: how can an untrained person use an AED and not kill? The good news is that this type of defibrillator does not shock everyone. This is a small device (no “irons” like in the movies, just stickers with electrodes that are attached to the chest), with simple instructions written on it, and usually in a voice, the defibrillator takes an ECG and asks everyone to move away if a shock is needed. A discharge may be necessary if a person has a serious heart rhythm disturbance (ventricular tachycardia or ventricular fibrillation) and the heart does not pump blood, but simply contracts chaotically. That is, an AED cannot restart a heart that is not beating, but it can restart a heart that is not beating properly. It makes sense to use an AED in the first 10 minutes after loss of consciousness (or better, in the first three). Sometimes several shocks are needed, and between them it is necessary to pump blood using chest compressions. By the way, mouth-to-mouth breathing is now not considered mandatory and dramatically increases a person’s chances of survival. If the rescuer is not trained, then mouth-to-mouth breathing is not recommended at all, especially since there should be enough oxygen in the blood until the ambulance arrives (of course, if this is the case when you are not far from civilization and the ambulance arrives quickly). Trained people can carry mouth-to-mouth breathing masks - they come in miniature sizes, which is very convenient.

In adults, indirect cardiac massage is performed with straight arms, clasping the hands with the knuckles up. In children this can be done with one hand, in infants - with two fingers. You need to apply pressure in the area of ​​the lower half of the sternum (this is the area between the nipples). It is good when the chest is depressed by 5-6 centimeters (in infants - by 4 centimeters). Of course, you can break your ribs this way, but they will heal, and indirect massage can save your life. It is necessary to apply pressure at a frequency of 100-120 beats per minute. If you do this to the rhythm of the song Stayin' Alive, it will do what you need.

But all this cardiopulmonary resuscitation is, of course, very, very difficult to carry out correctly without training, so let us remind you once again about the courses: they are free, take place mostly on weekends, and you can discuss with your superiors the visit of a trainer to your organization. But as a last resort, you can use online courses and all kinds of videos for training. This is considered to be an acceptable alternative. In the meantime, if you use the Telegram messenger, you can contact the bot, which will quickly provide you with an action algorithm.

Summary

If you see an unconscious person:

1. Make sure you are not in danger.
2. Turn to the person and shake his shoulder.
3. If not responding, check your breathing.
4. If the person is breathing, turn them to a safe position and call an ambulance. If he is not breathing, call an ambulance, send someone for an AED and begin resuscitation.

Diagnostic features

A patient with frequent occurrences of syncope is examined in the hospital using an ECG to refute or verify that such a condition is cardiac in nature. During the diagnosis, the following conditions are noted:

1. If a patient is under forty years of age and has no abnormalities in the cardiac structure on the cardiogram, then syncope is most likely caused by the presence of neurological disorders.
2. If a patient over forty years old has no lesions on the cardiogram, then the examination still begins with a detailed study of the condition of the heart.

In addition, you need to know the following:

• syncope caused by physical overexertion is not safe for people of any age group;
• the older the patient who experiences syncope, the greater the likelihood of having serious cardiac problems that caused this type of condition;
• if the duration of cardiac interruptions to the point of fainting is more than 5 seconds, then such interruptions are signs of serious heart disease;
• uncontrolled muscle twitching is quite often caused by temporary cerebral ischemia caused by the presence of heart disease;
• Even short syncope if a person has heart disease is usually considered a serious symptom.

It is especially dangerous if syncope is accompanied by the following factors:

• painful sensations behind the chest;
• in 60 seconds more than 160 heart contractions;
• heavy sweating;
• slow heartbeat;
• low pressure.

Providing first aid to victims

Photo: Victor Vasenin

The manual of the Ministry of Emergency Situations of Russia will help participants in road accidents and eyewitnesses of a heart attack in a sick person not to get confused in a difficult situation. The book also lists algorithms for providing first aid for traumatic injuries and emergency conditions. Such as external bleeding from injuries, abdominal wounds, penetrating chest wounds, bone fractures and thermal burns, as well as hypothermia and frostbite. Readers will learn how to behave correctly in order to actually help someone who has been electrocuted, or has swallowed water in a river, or perhaps has become a victim of serious poisoning. The manual also contains recommendations for help in case of injuries and chemical burns of the eyes, bites of poisonous snakes, insects, as well as heat and sunstroke.

Priority actions when providing first aid to sick and injured people

First of all, assistance is provided to those who are suffocating, who have profuse external bleeding, a penetrating wound to the chest or abdomen, who are unconscious or in serious condition.

Only after stopping external bleeding and restoring spontaneous breathing and heartbeat, do the following:

Procedure for performing cardiopulmonary resuscitation

2.1. Rules for determining the presence of a pulse, spontaneous breathing and the reaction of the pupils to light (signs of “life and death”)

Proceed to resuscitation only if there are no signs of life (points 1-2-3).

2.2. Sequence of artificial ventilation

2.3. Rules for closed (indirect) cardiac massage

The depth of chest compression should be at least 3-4 cm, 100-110 compressions per minute.

Closed cardiac massage should only be performed on a hard surface!

2.4. Removal of a foreign body from the respiratory tract using the Heimlich maneuver

Signs: The victim is suffocating (convulsive breathing movements), unable to speak, suddenly becomes cyanotic, and may lose consciousness.

Children often inhale parts of toys, nuts, and candies.

IF, DURING RESUSCIVATION, INDEPENDENT BREATHING, HEARTBEAT DOES NOT RECOVER, AND THE PUPILS REMAIN WIDE FOR 30-40 MINUTES AND THERE IS NO HELP, IT SHOULD BE CONSIDERED THAT THE BIOLOGICAL DEATH OF THE VICTIM HAS OCCURRED.

Algorithms for providing first aid to victims of traumatic injuries and emergency conditions

3.1. First aid for external bleeding

Pressure points of arteries

3.2. Methods for temporarily stopping external bleeding

Clamp the bleeding vessel (wound)

Finger pressure on the artery is painful for the victim and requires great endurance and strength from the person providing assistance. Before applying a tourniquet, do not release the pinched artery so that bleeding does not resume. If you start to get tired, ask someone present to press your fingers on top.

Apply a pressure bandage or pack the wound

Apply a hemostatic tourniquet

A tourniquet is a last resort measure to temporarily stop arterial bleeding.

The duration of the tourniquet on the limb is 1 hour, after which the tourniquet should be loosened for 10-15 minutes, having previously clamped the vessel, and tightened again, but not more than for 20-30 minutes.

Stopping external bleeding with a tourniquet (a more traumatic way to temporarily stop bleeding!)

3.3. First aid for abdominal wounds

Call (on your own or with the help of others) an ambulance and ensure that the victim is transported to a medical facility.

3.4. First aid for penetrating chest wounds

Signs: bleeding from a wound on the chest with the formation of blisters, air being sucked through the wound.

Call (on your own or with the help of others) an ambulance and ensure that the victim is transported to a medical facility.

3.5. First aid for nosebleeds

Causes: nose injury (blow, scratch); diseases (high blood pressure, decreased blood clotting); physical stress; overheating.

If the bleeding does not stop within 15-20 minutes, refer the victim to a medical facility.

3.6. First aid for broken bones

Call (on your own or with the help of others) an ambulance.

3.7. Rules for immobilization (immobilization)

Immobilization is mandatory. Only if there is a threat to the injured rescuer is it permissible to first move the injured person to a safe place.

3.8. First aid for thermal burns

Call (on your own or with the help of others) an ambulance. Ensure that the victim is transported to the burn department of the hospital.

3.9. First aid for general hypothermia

Call (on your own or with the help of others) an ambulance.

If there are signs of your own hypothermia, fight sleep, move; use paper, plastic bags and other means to insulate your shoes and clothes; look for or build a shelter from the cold.

3.10. First aid for frostbite

In case of frostbite, use oil or Vaseline; rubbing frostbitten areas of the body with snow is prohibited.

Call (on your own or with the help of others) an ambulance and ensure that the victim is transported to a medical facility.

3.11. First aid for electric shock

Call (on your own or with the help of others) an ambulance.

3.12. First aid for drowning

Call (on your own or with the help of others) an ambulance.

3.13. First aid for traumatic brain injury

Call (on your own or with the help of others) an ambulance.

3.14. First aid for poisoning

3.14.1. First aid for oral poisoning (when a toxic substance enters the mouth)

Call an ambulance immediately. Find out the circumstances of the incident (in case of drug poisoning, present the medicine wrappers to the arriving medical worker).

If the victim is conscious

If the victim is unconscious

Call (on your own or with the help of others) an ambulance and ensure that the victim is transported to a medical facility.

3.14.2. First aid for inhalation poisoning (when a toxic substance enters the respiratory tract)

Signs of carbon monoxide poisoning:

pain in the eyes, ringing in the ears, headache, nausea, vomiting, loss of consciousness, redness of the skin.

Signs of household gas poisoning:

heaviness in the head, dizziness, tinnitus, vomiting; severe muscle weakness, increased heart rate; drowsiness, loss of consciousness, involuntary urination, pale (blue) skin, shallow breathing, convulsions.

Call an ambulance.

Algorithms for providing first aid for acute diseases and emergencies

4.1. First aid for a heart attack

Signs:

acute pain behind the sternum, radiating to the left upper limb, accompanied by “fear of death,” palpitations, shortness of breath.

Call and instruct others to call an ambulance. Provide fresh air, unfasten tight clothes, and give a semi-sitting position.

4.2. First aid for damage to the organs of vision

4.2.1. If foreign bodies enter

The victim should only move hand in hand with an accompanying person!

Ensure that the victim is transported to a medical facility.

4.2.2. For chemical burns to the eyes

The victim should only move hand in hand with an accompanying person!

In case of acid contact

You can wash your eyes with a 2% solution of baking soda (add baking soda to a glass of boiled water on the tip of a table knife).

In case of contact with alkali

you can wash your eyes with a 0.1% solution of citric acid (add 2-3 drops of lemon juice to a glass of boiled water).

4.2.3. For eye and eyelid injuries

The victim should be in a lying position

Ensure that the victim is transported to a medical facility.

4.3. First aid for poisonous snake bites

Limit the mobility of the affected limb.

Ensure that the victim is transported to a medical facility for administration of anti-snake serum.

4.4. First aid for insect bites

If an allergic reaction occurs, consult a doctor. Monitor the patient's condition until a medical professional arrives.

4.5. First aid for fainting

Signs:

pallor, sudden short-term loss of consciousness.

If consciousness does not recover for more than 3-5 minutes, call (on your own or with the help of others) an ambulance.

4.6. First aid for heatstroke (sunstroke)

Signs:

weakness, drowsiness, thirst, nausea, headache; increased breathing and increased temperature, loss of consciousness are possible.

If these signs are absent, proceed with cardiopulmonary resuscitation.

Call (by yourself or with the help of others) an ambulance

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