What are the 5 steps for taking care of an unconscious patient?

According to the American Heart Association, effective bystander CPR can double or triple a person's chance of survival. When someone collapses, knowing what are the 5 steps for taking care of an unconscious patient can be the difference between life and death. This guide provides an authoritative roadmap for this critical emergency.

Quick Summary

Assessing an unconscious patient requires a structured approach involving checking for immediate dangers, calling for professional help, evaluating the patient's condition, administering CPR or positioning as needed, and monitoring them continuously until medical responders arrive.

Key Points

• Check for Safety: Never approach an unconscious patient if the scene is not safe.

• Call for Help: Contact emergency services (e.g., 911) immediately and provide clear details.

• Assess the Patient: Check for consciousness and breathing in a systematic manner.

• Act Based on Breathing: Begin CPR if not breathing normally or place in the recovery position if breathing.

• Monitor Continuously: Stay with the patient and observe their condition until medical help arrives.

• Do Not Give Liquids: Avoid giving an unconscious person anything to eat or drink.

Step 1: Ensure the scene is safe

Before you do anything else, your personal safety is the top priority. You cannot help someone else if you become another casualty. Take a moment to scan the environment for any potential dangers, such as traffic, fire, live electricity wires, or falling objects. Only approach the patient if the area is safe. If the unconscious patient is in a car that has been in an accident, or near a volatile substance, do not move them unless they are in immediate, life-threatening danger from the surroundings.

Step 2: Call for emergency medical services immediately

Once you have determined the scene is safe, call your local emergency number (such as 911 in the United States) without delay. This is arguably the most critical step, as professional medical help needs to be on the way as soon as possible. If someone else is with you, delegate this task to them. Instruct them to provide the dispatcher with a clear, concise report of the situation, including your exact location, the patient's status, and any known details about what happened. If you are alone, use a speakerphone so your hands are free to attend to the patient.

Communicating with the dispatcher

• Your location: State the exact address, cross-streets, or landmarks.
• The situation: Describe what you see, e.g., 'An adult male is unconscious and not breathing.'
• Patient details: Mention their age (approximate), any visible injuries, and if they have pre-existing medical conditions.
• Your actions: Explain what steps you are taking, such as starting CPR.

Step 3: Assess the patient's level of consciousness and check for breathing

Approach the patient carefully and gently tap or shake their shoulder, speaking loudly to them, for example, "Are you okay?" If there is no response, the patient is unconscious. Next, check for breathing. Look for the rise and fall of the chest, listen for breaths near their mouth and nose, and feel for airflow with your cheek. Perform this check for no more than 10 seconds. If they are not breathing normally (which includes gasping or irregular breathing), or you are unsure, proceed to the next step.

Airway management

If you do not suspect a neck or spinal injury, use the head-tilt, chin-lift maneuver to open the patient's airway. Gently tilt their head back and lift their chin forward to move the tongue away from the back of the throat. This simple action can be life-saving. For infants, a neutral or "sniffing" position is recommended.

Step 4: Perform CPR or place in the recovery position

The patient's breathing status dictates your next action.

If the patient is not breathing normally: Begin CPR immediately. For an adult, this involves performing high-quality chest compressions at a rate of 100 to 120 beats per minute, pushing hard and fast in the center of the chest. If you are trained, you can also incorporate rescue breaths. Hands-only CPR is recommended for untrained rescuers. You should continue CPR until medical professionals or an automated external defibrillator (AED) arrives.

If the patient is breathing normally: Carefully roll them onto their side into the recovery position. This prevents the patient from choking on their own vomit or secretions. To perform the recovery position:

1. Kneel beside the patient and straighten both of their legs.
2. Place the arm nearest you at a right angle to their body, with the palm facing up.
3. Bring the other arm across their chest and hold the back of their hand against the cheek nearest you.
4. With your other hand, grab the far leg just above the knee and pull it up, keeping the foot flat on the ground.
5. Pull the far leg towards you to roll the patient onto their side. The bent knee should keep them from rolling all the way onto their stomach.
6. Tilt their head back to ensure the airway is open.
7. Monitor their breathing continuously.

This technique is crucial for managing an unconscious patient who is breathing. For a visual guide to the recovery position, you can consult reliable sources like the American Red Cross.

Step 5: Monitor the patient until help arrives

Regardless of whether the patient is breathing or not, constant monitoring is necessary. Stay with the patient and watch for any changes in their breathing or overall condition. If they stop breathing, begin CPR. If they were in the recovery position and their condition changes, adjust your response. Remember these key points while you wait:

• Do not give them anything to eat or drink. This could cause them to choke.
• Keep them warm. Use a blanket or extra clothes to prevent shock.
• Do not leave the patient unattended. Their condition can change rapidly.
• Stay calm. Your calm demeanor can help reassure the patient if they regain consciousness and will help you remain focused.

Comparison Table: Breathing vs. Not Breathing

Condition	Primary Action	Secondary Action	Monitoring
Not Breathing	Initiate CPR immediately.	Use an AED as soon as one is available.	Check constantly for signs of breathing and consciousness.
Breathing Normally	Place patient in the recovery position.	Keep them warm with a blanket or coat.	Watch continuously for changes in breathing and position to prevent choking.

Conclusion

Facing an unconscious person can be frightening, but having a clear, structured plan can empower you to act effectively. Following the 5 steps for taking care of an unconscious patient—ensuring safety, calling for help, assessing the situation, acting appropriately, and monitoring carefully—maximizes the patient's chances of a positive outcome. While these steps are vital, they are not a substitute for formal first aid and CPR training. Consider taking a course to prepare yourself for these critical situations.

Frequently Asked Questions

What is the very first thing I should do when I see an unconscious person?

The very first thing you must do is check for and ensure the safety of the scene. Look for hazards like traffic, live wires, or other dangers before approaching the patient. Your safety is paramount.

How do I check if an unconscious person is breathing?

To check for breathing, use the 'Look, Listen, and Feel' method. Look for the rise and fall of the chest, listen for breath sounds near their mouth, and feel for airflow on your cheek for no more than 10 seconds. If you are unsure or see gasping, assume they are not breathing normally.

When should I put an unconscious patient in the recovery position?

You should place an unconscious patient in the recovery position only if they are breathing normally and you do not suspect a spinal or neck injury. This position helps keep their airway clear and prevents them from choking on vomit or fluids.

What should I do if a spinal injury is suspected?

If a spinal injury is suspected, you should avoid moving the patient as much as possible. Keep them in the position you found them and maintain a clear airway using the jaw-thrust maneuver, which avoids moving the neck. Never attempt a head-tilt/chin-lift if a neck injury is possible.

Is it safe to give an unconscious person water or food?

No, it is extremely dangerous to give an unconscious person any food or water. Their swallowing reflexes are impaired, and providing anything by mouth could cause them to choke or aspirate the substance into their lungs.

What if an unconscious person has a known medical condition like diabetes or epilepsy?

While knowing a pre-existing condition is helpful, your immediate first aid response remains the same. Do not try to administer any medication or treatment specific to their condition unless you are a trained professional. Focus on the core steps: securing the scene, calling for help, and managing their breathing and airway.

How can I tell the difference between someone sleeping and someone who is truly unconscious?

Someone who is sleeping will respond to loud noises or gentle shaking. An unconscious person will not respond to any form of external stimulation, such as verbal commands, shaking, or pain stimuli.