How to monitor an unconscious patient? A comprehensive guide to first aid

October 2, 2025 •

4 min read

According to the American Heart Association, prompt action in medical emergencies can be life-saving. Knowing how to monitor an unconscious patient is a critical skill for first responders and concerned individuals alike, ensuring the best possible outcome until professional help arrives.

Quick Summary

Monitoring an unconscious patient involves prioritizing safety by following the ABCs (Airway, Breathing, Circulation), placing them in the recovery position if safe, and continuously observing their vital signs and responsiveness. Call 911 immediately and provide a calm, clear assessment to the dispatcher to facilitate a rapid, effective emergency response.

Key Points

Initial Assessment: Prioritize safety and check the patient's Airway, Breathing, and Circulation (ABCs) immediately.
Recovery Position: If no spinal injury is suspected, place the patient on their side to prevent choking and maintain a clear airway.
Continuous Observation: Regularly monitor the patient's breathing rate, pulse, skin color, and level of consciousness using the AVPU scale.
Call for Help: Always call emergency services (911) immediately when you encounter an unconscious person.
Report Clearly: When speaking with a dispatcher or paramedics, provide a concise and calm summary of your observations and actions.
Protect from Harm: Guard the patient from environmental dangers and protect them from self-injury if they have a seizure.

Initial Assessment: The ABCs

When you find someone who appears unconscious, your first priority is to ensure their immediate safety and assess their condition using the ABC method. Always ensure the scene is safe for both you and the patient before approaching.

Airway

Gently open the patient's airway using the head-tilt, chin-lift method. Place one hand on their forehead and the fingertips of the other hand under their chin. Gently tilt their head back while lifting the chin forward to move the tongue away from the back of the throat. If a spinal injury is suspected, use the jaw-thrust maneuver instead to avoid moving the neck.

Breathing

After opening the airway, check for breathing. Use the 'look, listen, and feel' technique for no more than 10 seconds. Look for chest movement, listen for breath sounds, and feel for breath on your cheek. Normal breathing is quiet and regular. Gasping or irregular breathing is not normal and should be treated as no breathing.

Circulation

Check for a pulse, either at the wrist (radial artery) or the neck (carotid artery). To check the carotid pulse, place two fingers on the side of their neck, just below the jawline. If there is no pulse and the person is not breathing normally, begin CPR immediately if you are trained to do so. If the patient is breathing and has a pulse, focus on continuous monitoring.

The Recovery Position

If the patient is breathing and you have no reason to suspect a neck or spinal injury, placing them in the recovery position is critical. This prevents them from choking on their own vomit or saliva. The American Red Cross provides an excellent First Aid for Someone Unresponsive & Breathing guide on this.

Kneel beside the patient and straighten their legs.
Place the arm nearest you at a right angle to their body, with the elbow bent and the palm facing up.
Bring their other arm across their chest and hold the back of their hand against the cheek nearest you.
With your other hand, grab the far leg just above the knee and pull it up so the foot is flat on the ground.
Using the bent leg, roll the patient gently towards you and onto their side.
Adjust the top leg so the hip and knee are bent at right angles to stabilize the position.
Ensure the patient's head is tilted back to keep the airway open.

Continuous Monitoring and Assessment

Once the patient is in a safe position and emergency services have been called, continuous monitoring is paramount. Your job is to act as the patient's temporary lifeline, providing vital information to paramedics upon arrival.

Monitoring Vital Signs

Breathing Rate: Continuously watch and count the patient's chest movements. A normal adult breathing rate is 12-20 breaths per minute. Report any changes, such as very slow or rapid breathing.
Pulse Rate: Regularly check the patient's pulse. A normal adult pulse rate is 60-100 beats per minute. Note if the pulse is very fast, slow, or irregular.
Skin Color and Temperature: Check for changes in skin color, especially around the lips, gums, and nail beds. Pale or bluish skin can indicate poor circulation or lack of oxygen. Feel the patient's skin to check for temperature changes; cold or clammy skin could indicate shock.

Neurological Assessment: The AVPU Scale

The AVPU scale is a rapid method for assessing a patient's level of consciousness.

A - Alert: The patient is fully awake and responds to questions.
V - Responds to Voice: The patient responds to a verbal command but may be confused or drowsy.
P - Responds to Pain: The patient responds to a painful stimulus but does not respond to voice.
U - Unresponsive: The patient does not respond to any stimulus.


Feature	AVPU Scale (First Aid)	GCS (Professional)
Purpose	Quick, simple bedside assessment of responsiveness.	Detailed, standardized neurological assessment.
Assessment	Responds to Alert, Voice, Pain, or Unresponsive.	Assesses Eye, Verbal, and Motor responses with a numerical score (3-15).
User	Untrained or basic first responders.	Healthcare professionals in clinical settings.
Details	Lacks nuance, only provides a broad level of consciousness.	Highly specific, allows for consistent tracking of changes over time.
Action	Guides immediate first aid, informs 911 dispatch.	Guides treatment decisions, prognostication.

Conclusion

Monitoring an unconscious patient requires quick thinking, calm action, and continuous observation. Your primary role is to ensure the patient's ABCs are maintained and they are in a safe position until qualified medical help arrives. The information you gather and relay to paramedics can be invaluable for their subsequent care. Stay with the patient, continue to monitor their condition, and do not leave them unattended.

Frequently Asked Questions

First, ensure the scene is safe for you to approach. Then, check for responsiveness by gently tapping them and shouting, 'Are you okay?' If there's no response, call 911 immediately and begin assessing their ABCs (Airway, Breathing, Circulation).

After opening the patient's airway with a head-tilt, chin-lift, use the 'look, listen, and feel' technique. Look for the rise and fall of their chest, listen for breath sounds, and feel for breath on your cheek. Do this for no more than 10 seconds.

Place an unconscious patient in the recovery position only if you have confirmed they are breathing normally and you have no reason to suspect a head, neck, or spinal injury. This is a critical step to prevent choking.

If an unconscious patient is not breathing normally, call 911 immediately and, if you are trained in CPR, begin chest compressions. The 911 dispatcher can provide guidance over the phone.

No, it is not safe. If you suspect a spinal injury (e.g., from a fall or car accident), do not move the patient unless absolutely necessary for their safety, such as to perform CPR or get them out of immediate danger. Keep their head and neck stabilized until help arrives.

To check for a pulse, use two fingers to press gently on the side of the neck (carotid artery) or the wrist (radial artery). Feel for a regular beat and note if it is fast, slow, or irregular. Continue checking periodically.

Provide your location, what happened, the patient's level of consciousness (using AVPU), whether they are breathing, and any other observations you have made, such as visible injuries or changes in skin color. Stay on the line until instructed otherwise.