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Consciousness is maintained by impulses mediated via Grey Matter in the Reticular Activating System (R.A.S.)
Sleep is a physiological process which is usually accompanied by reduction of impulses in the R.A.S. The individual is easily arousable from sleep and basic protective reflexes are also intact. UNCONSCIOUSNESS: Unconsciousness is different from normal sleep in that unconscious subjects are not usually arousable and quite often, there is loss of or interference with basic protective reflexes such as: Maintenance of free airway Coughing and swallowing Withdrawal from noxious stimuli etc. Unconsciousness may be: a) Partial (semi-coma or stupor) b) Complete (coma) Accurate diagnosis of the cause of Unconsciousness is important for SPECIFIC TREATMENT but for the GENERAL CARE of the patient, level of consciousness is more important.
CAUSES OF UNCONSCIOUSNESS INCLUDE: 1) SHOCK 2) ASPHYXIA 3) POISONING 4) HEAD INJURY 5) CEREBROVASCULAR ACCIDENTS (STROKE) 6) EPILEPSY 7) HYSTERIA 8) INFANTILE CONVULSIONS 9) HYPOTHERMIA OR HYPERTHERMIA 10)DIABETES MELLITUS HYPO/HYPER 11) FAINTING/SYNCOPE, VASOVAGAL ATTACKS 12) HEART ATTACKS 13)OTHERS E.G. - MENINGO ENCEPHALITIS - FLUIDS AND ELECTROLYTE DISORDERS
CARE
1) Emergency care or first aid
a)
artificial respiration immediately. This is easier with the patient in supine position. 4. Next, check the pulse and out external chest compression if there is no pulse. In the absence of both pulse and breathing, carry out the sequence of one-rescuer CPR until help arrives. 1. If both breathing and pulse are present, loosen all tight clothing, and treat any obvious life threatening injury such as profuse bleeding. 2. Give oxygen by mask if available and elevate the legs if the pulse is feeble or fast. 3. Place and support the casualty in the semi-prone or "tonsil" position. 4. Do not leave the patient unattended unless absolutely necessary and constantly watch the breathing and check the pulse. 5. Do not administer any oral fluids or food to an unconscious subject. 6. Keep warm with blanket if necessary but do not apply heat. 7. Remove the subject to medical aid (hospital) as soon as possible and preferable on a stretcher.