Dealing with Someone who is Unconscious

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This leaflet is created from first aid advice provided by St John Ambulance, the nation's leading first aid charity. This advice is no substitute for first aid training - find a training course near you.

If you see someone who has collapsed, you need to confirm whether they are unconscious and breathing or unconscious and not breathing.

The safest thing to do is get professional help as quickly as possible. If other people are around, get someone to dial 999/112/911 for an ambulance. If you are alone, shout for help and as soon as someone arrives get them to dial 999/112/911 for an ambulance.

Unconscious and breathing

DRAB survey

While you are waiting for help to arrive, follow the primary DRAB survey steps - Danger, Response, Airway, Breathing.

Danger

Check that neither you nor the unconscious person are in any danger. If necessary make the area safe and then assess them.

Response - unconscious adult or child

If you are still alone, shout for help again, then see if the person responds:

  • Shout at them - for example: 'Can you hear me?' or 'Open your eyes'.
  • Gently shake their shoulders.

Response - unconscious infant

If it is an unconscious infant (under 12 months), to check for a response:

  • Tap or flick the sole of an infant's foot to try to elicit a response.
  • Do not shake an infant.

Airway

If they respond, they are breathing but check for severe bleeding and other injuries. You may need to help them to breathe by opening their airway:

  • Place one hand on the forehead and, using two fingers, lift the chin.

Breathing

If they don't respond, you need to check if they are breathing:

  • Position your cheek close to their mouth.
  • Look, listen and feel for no more than 10 seconds:
    • Look to see if the chest is rising and falling.
    • Listen for breathing.
    • Feel the breath against your cheek.

If they are breathing put them in the recovery position until help arrives:

  • Turn them on to their side.
  • Lift chin forward in open airway position and adjust hand under the cheek as necessary.
  • Check they cannot roll forwards or backwards.
  • Monitor breathing continuously.
  • If injuries allow, turn them to the other side after 30 minutes.

If help still hasn't arrived, dial 999/112/911 for an ambulance.

Unconscious and not breathing

Having completed the DRAB survey steps above and established the person is not breathing, give cardiopulmonary resuscitation (CPR). This is a technique whereby oxygen is pumped around the body, using a combination of chest compressions and rescue breaths.

Unconscious and not breathing adult

  • Chest compressions:
    • Place the heel of your hand (the base of your thumb) in the centre of the chest.
    • Place your other hand on top and interlock fingers.
    • Keeping your arms straight and your fingers off the chest, press down by five to six centimetres and release the pressure, keeping your hands in place.
    • Repeat the compressions 30 times, at a rate of 100-120 per minute (about the speed of the song 'Staying Alive' or 'Nelly the Elephant').
  • Next give 2 rescue breaths:
    • Ensure the airway is open.
    • Pinch their nose firmly closed.
    • Take a deep breath and seal your lips around their mouth.
    • Blow into the mouth until the chest rises.
    • Remove your mouth and allow the chest to fall.
    • Repeat once more.

If you are unable, unwilling or untrained to give rescue breaths, give chest compressions only and continue at a rate of 100-120 per minute.

If help still hasn't arrived, dial 999/112/911 for an ambulance, then reassess and continue with CPR or just chest compressions until the ambulance arrives.

Unconscious and not breathing child

If it is an unconscious child (1 year to puberty) who is not breathing, start with rescue breaths:

  • Ensure the airway is open.
  • Seal your lips around the child's mouth.
  • Blow gently into their lungs, looking along the chest as you breathe.
  • As the chest rises, stop blowing and allow it to fall.
  • Repeat this 5 times.

Then give compressions:

  • Place one or two hands in the centre of the chest (depending on the size of the child). You can do this without removing the child's clothes.
  • Use the heel of that hand with arms straight and press down to a third of the depth of the chest.
  • Press 30 times, at a rate of 100-120 compressions per minute (about the speed of the song 'Staying Alive' or 'Nelly the Elephant').

After 30 compressions, give 2 more rescue breaths and If help still hasn't arrived dial 999/112/911 for an ambulance. Repeat the sequence of 30 chest compressions and 2 rescue breaths until help arrives.

Unconscious and not breathing infant

If the infant is not breathing, start with 5 rescue breaths as for a child, followed by compressions:

  • Place the baby on a firm surface.
  • Locate a position in the centre of the chest - it is possible to identify the correct hand position without removing the infant's clothes.
  • Using two fingers, press down sharply to a third of the depth of the chest.
  • Press 30 times, at a rate of 100-120 compressions per minute.

After 30 compressions, give 2 more rescue breaths and if help still hasn't arrived, dial 999/112/911 for an ambulance. Repeat the sequence of 30 chest compressions and 2 rescue breaths until help arrives.

Note: these hints are no substitute for thorough knowledge of first aid. St John Ambulance holds first aid courses throughout the country.

 

Adapted from the St John Ambulance leaflets: unconscious breathing adult, unconscious and breathing child, unconscious and breathing babyunconscious and not breathing adult, unconscious and not breathing child and unconscious and not breathing baby. Copyright for this leaflet is with St John Ambulance.

Original Author:
St John Ambulance
Current Version:
Peer Reviewer:
St John Ambulance
Document ID:
28502 (v1)
Last Checked:
15/08/2013
Next Review:
14/08/2016

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