Loss of consciousness is a situation in which there is a complete lack of awareness and the ability to react to all stimuli of the environment (e.g. heat, cold, stinging, noise, etc.). This situation is an external expression of a disturbance in the functioning of the central nervous system.

What is loss of consciousness?

Loss of consciousness is a complete loss of consciousness and the inability to react to external stimuli (e.g. heat, cold). The unconscious does not answer questions or react to shaking his shoulders. Loss of consciousness that lasts a maximum of 1-2 minutes and resolves on its own is called fainting. In itself, it is not life-threatening, as breathing and circulation are not stopped. Falls that occur during fainting and associated head injuries (e.g. concussion) are more dangerous. Any loss of consciousness is a life-threatening condition, therefore first aid is very important. In young people, the most common occurrence is hypoxia due to short-term cerebral ischemia. The effects of loss of consciousness are sometimes tragic, as it may lead to airway obstruction, and after a few seconds of cardiac arrest and death. Certain medical conditions lead to an apparent loss of consciousness, such as ischemic attack or cataplexy.

The causes of loss of consciousness

Loss of consciousness can occur for a variety of reasons, but is most often due to:

1. brain blood supply disorders (e.g. hypoxia,hemorrhages, blood clots),
2. stroke_
3. congestion,
4. general exhaustion of the body,
5. internal organ dysfunction,
6. thermal regulation disorders (e.g. overheating of the body) and excessive cooling of the body,
7. exposure to electric current – extensive burns may appear at the point of contact with electricity,
8. hypoglycaemia– in the patient the loss of consciousness ends in a coma, and the lack of first aid may lead to the patient’s death,
9. various types of poisoning with substances of external origin (e.g.carbon monoxide),
10. disorders of the intracorporeal metabolism, leading to the accumulation of harmful products in the body (e.g. in renal failure –uremia– uremic coma, in liver failure – hepatic coma),
11. increase or decrease in the concentration of physiological components (e.g. sugars – diabetic coma),
12. mechanical injuries (e.g.concussion), etc.
13. heart rhythm disturbances,
14. intense physical effort,
15. subclavian steal syndrome – in addition to loss of consciousness, there is weakness in the upper limbs,
16. anemia,
17. a sudden change in body position,
18. stress,
19. severe pain,
20. transient ischemia of the brain – loss of consciousness is accompanied by speech disorders, dizziness and visual disturbances (very slowly comes to consciousness),
21. carotid sinus syndrome – any movement of the neck and head compresses the carotid artery, causing loss of consciousness,
22. head injuries (direct damage to the brain tissue through trauma),
23. epilepsy, febrile cramps – loss of consciousness with urinary incontinence and convulsions,
24. autonomic failure – loss of consciousness after consuming a heavy meal,
25. stay in poorly ventilated rooms.

The most common states of loss of consciousness in which conscious and appropriate non-medical first aid is possible and even necessary include:

1. unexpected failure of the heart and breathing
2. fainting_
3. heat and sunstroke,
4. poisoning, e.g. with light gas and carbon monoxide,
5. low blood sugar,
6. vascular changes of the brain.

Loss of consciousness – types

1. reflex loss of consciousness– may be caused by stress or a change in body position. Then, the blood pressure is lowered and the blood supply to the central nervous system is reduced. Patients with this type of syncope show a rapid recovery. In addition, predictive symptoms are observed. In addition to loss of consciousness, auditory sensations, nausea, and vomiting may occur;

2. cardiogenic syncope– this is the second type of syncope (in terms of frequency). They are most often caused by a disturbance of the heart rhythm and reduced blood flow to the brain. If the loss of consciousness occurred during intense physical exertion or was preceded by palpitations – cardiogenic causes are suspected;

3. orthostatic hypotension– loss of consciousness is associated with a change in body position (especially after rapid upright standing). The cause of fainting is circulatory disturbance. In addition, there are dizziness, visual disturbances, palpitations and tiredness;

4. situational loss of consciousness– occurs during urination, defecation or coughing.

Symptoms of loss of consciousness

Before you pass out, you may experience some symptoms:

1. dizziness,
2. severe headache,
3. dyspnoea,
4. spots in front of the eyes,
5. tinnitus
6. pale skin,
7. feeling hot
8. nausea,
9. excessive sweating
10. faster heartbeat.

On the other hand, people who have lost consciousness, after regaining consciousness, complain of drowsiness, headaches, confusion (they don’t know what just happened), weakness and muscle pain. The unconscious does not react to asked questions or external stimuli. In addition, he has very flaccid muscles. A certain group of people do not have symptoms at all.

Loss of consciousness – first aid

The degree of loss of consciousness is assessed according to GCS (Glasgow scale) and during neurological examinations (checking the patient’s reaction to stimuli). If the patient reacts only to louder calls or strong stimuli – we are talking about a shallow loss of consciousness. On the other hand, when he does not react to screams, he is completely unconscious.

Before first aid is provided, you should check whether the scene is safe. If you suspect carbon monoxide poisoning, evacuate the victim from the apartment as soon as possible and call an ambulance. Next, check whether the victim is conscious – to do this, gently shake him by the shoulders. It is also important to check the airway patency of an unconscious person – you should lean over the unconscious person’s head and bring your ear closer to his mouth and nose and place your hand on the chest. If the injured is breathing – you will hear the sound of the air being inhaled, the warmth of the exhaled air and the movement of the chest. If necessary, the airway should be opened and the patient should be placed in a recovery position. This position should be used by people who

The presence of external wounds in the victim requires their treatment, and fractures – immobilization. Until the arrival of the ambulance, you should systematically control the breathing of the unconscious and make sure that there is no possible vomiting.

Every loss of consciousness requires the assessment of the victim!

Loss of consciousness in a child

First aid in the event of a loss of consciousness in a child also consists of trying to make contact with him verbally, and if that does not help, by gently shaking it. When assessing the child’s condition, the possibility of a cervical spine injury should be determined. When the child reacts, it should be left as it is, unless there is an additional risk. Remember to open the airway by placing the child in a safe position and regularly assessing the breathing. In addition, it is worth covering the injured toddler to prevent hypothermia.

The lack of reaction of the child to verbal contact and gentle shaking is an indication for an immediate call for an ambulance and for turning the child on his back. Don’t leave your baby alone! After laying the toddler on his back, place one hand on his forehead, while two fingers of the other hand on the chin and gently tilt the head back. If the airways are clear, normal breathing and chest movement should be normal. If the chest does not rise despite the audible sounds, begin CPR.

People who lost consciousness should see a doctor after regaining it for: laboratory tests, imaging tests, ECG and glycemia. They will help you find the cause of your fainting and prevent similar situations in the future.