Unconsciousness

For an unconscious patiet the most important initial nursing care is maintaning
an airway. Following this are observations of: breathing; circulation; and
neurological function. General observations may indicate the cause of
unconsciousness. When discussing the patient, the nurse and those in the
immediate area should remember that in some levels of unconsciousness the
patient can hear everything that is said.
Important observations to notify to the nurse or doctor in charge:
1.
2.
3.
4.
5.
6.

Deteriorataring levels of consciousness

Increasing blood preassure
Decreasing pulse rate
Changes in pupil reaction
Leakage of cerebrospinal fluid from the nose or ears
Gross abnormality of temperature control

Please note that an unconscious patient may also have other changes in the
blood pressure and pulse recordings. If the patient is suffering from severe
aemorrhage following multiple injuries elsewhere in the body, he or she will
produce the features of shock, i.e., hypotension and tachycardia.
Patient Care
The following points must be considered for care of the unconscious patient:
1. Maintenance of an airway
2. Position of patient. An unconscious patient is generally nursed in a
semiprone position but be aware of the patients condition before he or
she is moved to a semiprone position. A patient with spinal injuries, for
instance, should be nurse in a recumbent position or a lateral position
only, the spine must be kept straight during movement and at rest
3. Movement of patient. If an unconscious patient remains in the accident
and emergency departement for any length of time his or her position
must be changed every 2 hours to prevent the development of preasure
sore. Observe any areas liable to preasure, noting any redness or
breakdown of the skin
4. Observations. These must be carried out at 15 minutes intervals