Unconscious Patient Flashcards
Clinical Severity Prompts (2)
Glasgow Coma Scale (GCS) less than 9
Inability to maintain own airway
History Prompts (6)
Onset
Events - mechanism of injury
Associated preceding symptoms
Relevant past history - especially diabetes and alcohol use
Medication history - especially narcotic use
Allergies
Airway - Assessment
Assess patency
Airway - Intervention
Maintain airway patency
Stabilise the C-spine with in-line immobilisation and apply a semi-rigid cervical collar (if there is a possibility of injury)
Breathing - Assessment
Respiratory rate & effort
SpO2
Auscultation
Breathing - Intervention
Assist ventilation if required
Apply O2 to maintain SpO2 > 95%
Circulation - Assessment
Skin temperature (touch)
Pulse - rate & rhythm
Capillary refill
Blood pressure
Cardiac Monitor
Circulation - Intervention
IV cannulatio / pathology
If SBP < 90mmHg give IV 0.9% NaCl 500ml bolus
Monitor vital signs frequently
Disability - Assessment
AVPU / GCS + pupils
BGL
Possible opiate overdose (characterised by pin-point pupils & hypoventilation)
Disability - Intervention
Monitor LOC frequently
If GCS < 9 & not rapidly improving, the patient will require endotracheal intubation by a MO to protect airway from aspiration.
Consider LMA insertion if GCS = 3 & airway difficult to maintain (LMA does NOT protect the airway from aspiration)
If BGL < 3mmol/L and unconscious or confused administer IV 50% Glucose 50ml
or (if no IV access)
IM Glucagon 1mg
Monitor BGL every 15minutes until within normal limits
If opiate overdose, give IM Naloxone 800mcg and IV Naloxone 800mcg
Measure & test - Intervention
Collect blood for FBC, UEC (consider group & hold in trauma patients)
Nil by mouth
IV 0.9% NaCl 1000ml @ 125ml/hr to maintain hydration
Fluid balance chart
12-lead ECG
Measure & Test - Assessment
Pathology
Temperature
U/A
Fluid input/output
Electrocardiography
Specific Treatment…?
If possible alcohol abuse give IM Thiamine 100mg
