American Medical Association Family Medical Guide - American Medical Association [118]
Unconsciousness
When a person is unconscious, the body’s normal reflexes are not functioning. The person will not respond to attempts to rouse him or her. The main danger when a person is unconscious is obstruction of the airway, which can result when the tongue or some other object such as food or vomit blocks the airway. Some causes of unconsciousness include heart attack (see previous page), stroke (see page 669), head injury (see page 167), severe bleeding (see next page), severe burn (see page 163, diabetic coma (hypoglycemia; see page 897), broken bones (see page 167), poisoning (see page 169), drug overdose, heatstroke (see page 166), choking (see page 155), a severe allergic reaction to food or to an insect bite or sting (see page 170), snakebite (see page 172), and an electric shock or lightning strike (see page 163).
Call or have someone call 911 or your local emergency number, or send someone for help. If you can’t call or send for help, take the person immediately to the nearest hospital emergency department. Do not leave an unconscious person alone.
How to Treat a Person Who Is Unconscious
If the person is not breathing:
1. Start mouth-to-mouth resuscitation immediately (see page 156). If the person has no heartbeat, perform CPR if you have had CPR training.
If the person is breathing:
1. Don’t move the person, especially if you think he or she may have a neck or back injury.
2. If you are sure that the person does not have a neck or back injury, place him or her on his or her side (to prevent choking), with the head tilted back slightly (to open the airway) and lower than the rest of the body (to drain fluids).
3. Loosen any tight clothing, particularly around the person’s neck, and keep him or her comfortable and warm.
4. Do not give the person anything to eat or drink.
Severe Bleeding
Blood flow from a vein usually flows more slowly and steadily than blood flow from an artery, which usually spurts from a wound. Large quantities of blood can be lost very rapidly from a severed or torn artery. In a severe wound, blood may flow so freely that there is no chance for a clot to form. Severe blood loss can lead to shock and unconsciousness and, if the bleeding is not stopped, can be fatal. Blood loss is considered severe if an adult loses more than 1½ pints of blood or if a child loses ½ pint of blood.
The body normally seals a wound by contracting the muscles in the wall of a damaged artery and forming a blood clot. If the blood does not clot for any reason, such as because the person has hemophilia (see page 618) or is taking anticlotting medications (see page 563), bleeding will be more difficult to control. The goal of first aid is to stop the flow of blood as quickly as possible (see next page). Call or have someone call 911 or your local emergency number, or send someone for help. If you can’t call or send for help, take the person immediately to the nearest hospital emergency department.
Severed Arm, Leg, Finger, or Toe
If a person has severed a limb, finger, or toe, the first concern is saving the person’s life. Call or have someone call 911 or your local emergency number, or send someone for help. If you have the severed body part, tell hospital personnel. Get the person and the severed part to a hospital emergency department immediately.
A person who has severed a body part is usually bleeding profusely. To treat severe bleeding, see next page.
The longer the severed part