We must act quickly- unconscious patient!

Why is the Unconscious Patient a life-threatening emergency?

We must act quickly- unconscious patient!

From our Trainers perspective – Lee Peak


  • Responds to Voice
  • Responds to Pain
  • No response or Unconscious.

AVPU. You commonly see it on Patient Care Reports (First Aid documentation).

Sleeping is not regarded as being Unconscious. That’s a story for another day.

I tend to use the C.O.W.S Akronmenms to check for a response. It is well known.

  • Can you hear me?
  • Open your eyes
  • Squeeze my hands
  • What’s your name?

This approach is well rounded and should arouse anyone who will respond. To obtain a good response in Infants (0-1 years), try squeezing their feet. That really aggravates them.

If you’re not getting any feedback from your unresponsive patient, try a Sternal Rub. This is where you rub your knuckles along the breastbone/sternum, and this causes intense pain. In my experience, this is a good go to point for an intoxicated patient (Drugs and/or Alcohol). If your patient still doesn’t respond, this is an emergency.

When you are Unconscious, we lose some very important reflexes and our Muscle Tone.

Let me explain.

Our Upper Airway (inside our throat) is supported by muscles. When we lose consciousness, these muscles become flaccid and are no longer supportive. (Particularly the large tongue relaxes, falls back, and obstructs)

We also lose the ability to swallow, cough, and gag (Reflexes). When this happens, we stop breathing.

We must act quickly.

  1. Dangers
  2. Response (C.O.W.S)
  3. Send for help if not Responsive.
  4. Airway DO NOT TILT THE HEAD BACK YET (Open the mouth and check for removable debris)
  5. Breathing. If the Airway is clear, now tilt the head back in an adult and half for a child.
    1. Look Listen and Feel for at least 10 seconds
    2. IF Breathing, Roll onto the side. Once in the recovery position, extend the head backwards to open the Airway.
    3. If no breathing, start CPR
  6. CPR
  7. Defibrillation

If we Hyper-extend the Arway (tilt) to open the Airway before it is cleared, the patient may inhale what is sitting in the mouth and upper Airway causing a blockage. (Full Tilt for an Adult, Half Head Tilt for a Child 1-8 years, and NO head tilt for an Infant 0-1 years)

Quite often, the patient is not breathing well or not at all because the Airway is blocked by the Tongue which is attached to the lower Jaw. Achieving a head tilt pushes forward the lower Jaw opening the space to breathe. This can trigger a sudden deep breath or inhalation on occasion and thankfully resuscitation is not required.

Remember to regularly check the ABCs of your patient. And ALL unconscious AND breathing must be rolled into the recovery position regardless of any other injury. This protects the Airway.

Please note that at this level of skill HLTAID011 there is no scope of training for a Jaw Thrust or Airway Adjuncts (Advanced Resuscitation).

Take care,

Download for your Team the following:

How to have conversations at work or at home?

  • Place this action plan in the lunch room or in a highly visible area
  • Include this resource in your staff newsletter
  • Arrange First Aid Training for your Team so they can be more prepared to manage the situation To book your team visit
  • For more information please visit www.growttraininggroup.com.au

It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition.