AMAN FOUNDATION CONTROL AND COMMAND

UNCONSCIOUNESS/ FAINTING (NEAR) Protocol 31

BY: AHMED AHMED

“Unconsciousness” is a Level of consciousness from which an individual cannot be aroused, even with painful stimulation.

“FAINTING” (syncope)Fainting due to a drop in blood pressure and a decrease of the oxygen supply to the brain is a temporary loss of consciousness.

Reticular activating system (RAS)

The involved in most central nervous system activity, including control of wakefulness, sleep and part of our ability to direct attention toward specific areas of our conscious minds. The RAS is a primitive network of interlacing nerve cells and fibers that receives input from multiple sensory pathways. It extends from the spinal cord to the lower brain stem, upward through the mesencephalon and thalamus, and then is distributed throughout the cerebral cortex. RAS fibers affect the autonomic and motor systems. They integrate the regulation of cardiovascular, respiratory and motor response to external stimuli.

Cardiac arrest

Fitting Head injury

Irregular heart rhythm Overdose, poisoning, drugs

Respiratory insufficiency

Causes of Unconsciousness

Causes of Unconsciousness

Diabetic problems

Heart attack shock

IntoxicationHypovolemic

shock

RULES

An unconscious person in whom breathing cannot be verified by a 2nd party caller (with the patient)is considered to be in cardiac arrest until proven otherwise.

Stay on line with the caller when the patient is still unconscious to ensure ABCs until responders arrives.

The initial chief complaint of fainting, even if the patient is unconscious and not breathing(or if breathing status is uncertain) should be handled on protocol 12.

RULES

Ground-level falls caused by fainting , near fainting, or dizziness should be handle on protocol no 31.

The airway of unconscious patient must be constantly maintained.

An unconscious pregnant patient in her 3rd trimester should be placed on her side with a pillow or like object wedged behind her lower back. Airway and CPR instructions should then be completed in this position.

ENTERY QUESTIONS

KEY QUESTIONS

Codes:

POST DISPATCH INSTRUCTIONS

I am organizing help for you now.Stay on line and I’ll tell you exactly what to do next.

Stay on the line with caller if her/his condition seems unstable or is worsening.

Link to X-1 unless

Unconscious

INEFFECTIVE BREATHING and NOT alert

Control Bleeding Nosebleed Control

ABC-1ABC-1X-5X-5a

DISPATCH LINK SUPPORT

ABC's of Life: A = Airway, B = Breathing, C = Circulation

If the victim is breathing and in no need of chest compressions and CPR, the victim should be placed in the recovery position. The recovery position helps keep the victim's airway open. To put the victim in the recovery position grab the victim's leg and shoulder and roll him or her towards you.

CPR PERFORM

RECOVERY POSITION

Opening the airway with a head tilt-chin lift maneuver

Looking, listening and feeling for

breathing

Perform chest compressions to support circulation

CPR INSTRUCTIONS TO DIFFERENT AGE

CATAGORIES

INFANT < 1 year•Compression:Push down 1 inch (3cm) with only one finger touching the chest.•Breathing:Cover the nose anh mouth with your mouth.

CHILD 1-7 yearsCompression:Push down 1 ½ inches (4cm) with only the heel of one hand touching the chest.

ADULT > 8 yearsCompression:Push down 2 inches (5cm) with lower hand touching the chest.

VIDEOS

X-CARDCONTROL BLEEDING:Do not use a tourniquet.(Tourniquet already applied) do not remove the tourniquet. let the ambulance crew deal with it.Get clean, dry cloth or towel and place it right on the wound. Press down firmly and don’t lift it up to look.If it keeps bleeding, you’re probably not pressing hard enough. Remember, keep firm, steady pressure on the wound.

NOSEBLEED CONTROL:Tightly pinch the entire soft part of her/his nose, right under the nasal bone, and hold it firmly until help arrives. Do not sniff or blow.(non-traumatic) Tell him/her to sit forward and keep still.

Monitor and maintain patient's airway, especially

if patient is nauseated or vomiting or if the level

of consciousness is decreased.

Lay patient on his back and monitor respirations.

Turn patient on their side if vomiting occurs.

Do not place pillow under patient's head.

do not give food or drink.

Calm and reassure patient.

Call back if the patient's condition changes

before help arrives.

Instructions Commonly Provided:

EXPERIENCE

EC #Call time:EMD: TimnaDispatch code:Ambulance:Response time:

52%40%

8%

TOTAL NO OF CASES 1322

MALE FEMALE CHILDREN

GENDER WISE REPORT

E(Echo)D(Delta)

C(Charlie)A(Alpha)

0%

20000%

40000%

60000%

80000%

100000%

120000%

140000%

16 1

5

1249

41

EMERGENCIES LEVEL WISE

OCT-18,2010 to FEB-28,2011

DELTA CASSES PROTOCOL WISE

0 4 2 0

44

2 3

2615

71

15

76

TOTAL CASSES: 234

MALIR

BIN QASIM

KORANGI

GULBERG

NORTH KARACHI

NORTH NAZIMABAD

SITE AREA

CLIFTON

BALDIA TOWN

PECHS

0 50 100 150 200 250

149

230

196

151

150

126

71

112

87

50

STATIONS WISE EMERGENCIES

HOSPITAL-HOSPITAL

HOME-HOSPITAL

HOSPITAL-HOME

ROADSIDE-HOSPITAL

FIRST AID

0% 20% 40% 60% 80% 100%

613

468

3

13

11

EMERGENCY DISPATCH

Any Question

?