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

Causes of Unconsciousness

Overdose,
Irregular heart rhythm
poisoning, drugs
Respiratory
insufficiency
Diabetic problems Heart attack shock

Causes of Unconsciousness

Intoxication Hypovolemic 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.
 DISPATCH LINK SUPPORT

Link to X-1 unless

Unconscious ABC-1
ABC-1
INEFFECTIVE BREATHING and NOT alert
Control Bleeding X-5
Nosebleed Control X-5a
 RECOVERY POSITION CPR PERFORM
ABC's of Life: A = Airway, B = Breathing, C = Circulation

Looking, listening and Opening the airway with a head

feeling for breathing tilt-chin lift maneuver

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.

Perform chest compressions to support circulation

 CPR INSTRUCTIONS TO
DIFFERENT AGE CATAGORIES

CHILD 1-7 years INFANT < 1 year ADULT > 8 years

Compression: •Compression: Compression:
Push down 1 ½ inches Push down 1 inch Push down 2 inches
(4cm) with only the (3cm) with only one (5cm) with lower
heel of one hand finger touching the hand touching the
touching the chest. chest. chest.
•Breathing:
Cover the nose anh
mouth with your
mouth.
VIDEOS
 X-CARD
CONTROL 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.
Instructions Commonly Provided:
 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.
 EXPERIENCE

EC #
Call time:
EMD: Timna
Dispatch code:
Ambulance:
Response time:
GENDER WISE REPORT

TOTAL NO OF CASES 1322

MALE FEMALE CHILDREN

8%

52%
40%
 EMERGENCIES LEVEL WISE
OCT-18,2010 to FEB-28,2011

140000% 1249

120000%
100000%
80000% 41
60000%
16
40000%
15
20000%
0%
E(Echo)
D(Delta)
C(Charlie)
A(Alpha)
DELTA CASSES PROTOCOL WISE

76
71
TOTAL CASSES: 234
44

26
15 15
4 2 2 3
0 0
STATIONS WISE EMERGENCIES

PECHS 50
BALDIA TOWN 87
CLIFTON 112
SITE AREA 71
NORTH NAZIMABAD 126
NORTH KARACHI 150
GULBERG 151
KORANGI 196
BIN QASIM 230
MALIR 149
0 50 100 150 200 250
 EMERGENCY DISPATCH

FIRST AID
11
ROADSIDE-HOSPITAL
13
HOSPITAL-HOME
3
HOME-HOSPITAL
468
HOSPITAL-HOSPITAL
613
 Any
Question?