Finding someone unresponsive on the floor is a medical emergency. An unresponsive person is not awake, does not respond to touch or sound, and may not be breathing normally. Immediate action is required.
Ensuring Safety and Calling for Help
Before approaching an unresponsive person, it is essential to prioritize your own safety and the safety of others. Carefully scan the immediate area for potential hazards such as live electrical wires, oncoming traffic, hazardous materials, or unstable structures. You should only approach the person once you are certain the scene is safe, as becoming a second victim would hinder, not help, the situation.
Once the scene is deemed safe, immediately call emergency medical services (EMS) by dialing 911 (or your local emergency number). If other people are present, clearly direct one specific individual to make the call while you attend to the person. This prevents confusion and ensures help is on the way promptly.
When speaking with the dispatcher, provide clear, concise information. State your exact location, including street address, cross streets, or any identifiable landmarks. Describe the nature of the emergency, specifically that you have found an unresponsive person, and briefly explain their apparent state, such as whether they are breathing or not. The dispatcher may ask additional questions to guide you through initial care or to better prepare the arriving emergency personnel.
Initial Patient Assessment
After activating emergency services, quickly assess the unresponsive person’s condition. Begin by checking for responsiveness by gently tapping their shoulder and shouting loudly, “Are you okay?” or “Can you hear me?” If there is no response, repeat these actions a couple of times to confirm their unresponsiveness.
Next, determine if the person is breathing normally. Open their airway by gently tilting their head back and lifting their chin. Then, look for the rise and fall of their chest, listen for breath sounds, and feel for air movement on your cheek, observing for no more than 10 seconds. Normal breathing should be regular and effortless; gasping or noisy breathing is not considered normal and suggests a problem.
Simultaneously, check for a pulse by feeling for the carotid artery in their neck, located beside their windpipe. Place two fingers gently on this artery for 5 to 10 seconds. A lack of pulse, or uncertain pulse, combined with absent or abnormal breathing, indicates a severe emergency requiring immediate action. Briefly observe for any obvious signs of severe injury or bleeding, but do not spend too much time on this initial assessment, as speed is crucial. Unless absolutely necessary for safety or to initiate life support, avoid moving the person.
Providing Basic Life Support
If the person is unresponsive and not breathing normally, or has no pulse, begin cardiopulmonary resuscitation (CPR) immediately. Position yourself kneeling beside the person and place the heel of one hand in the center of their chest, between the nipples, with the other hand on top.
Deliver chest compressions that are hard and fast, pushing down at least 2 inches (5 cm) deep at a rate of 100 to 120 compressions per minute. Allow the chest to fully recoil after each compression. Continue these compressions without interruption until emergency medical personnel arrive or the person shows signs of regaining consciousness, such as moving or breathing normally. For a layperson, hands-only CPR, focusing solely on continuous chest compressions, is often recommended.
If the person is unresponsive but breathing normally, place them in the recovery position. This helps maintain an open airway and prevents aspiration of vomit or fluids. To do this, straighten their legs, place the arm closest to you at a right angle to their body with the palm up, and bring their other arm across their chest, placing the back of their hand against the cheek closest to you. Bend the knee furthest from you and pull it up so their foot is flat on the floor, then carefully roll them onto their side by pulling on the bent knee. Once on their side, adjust the top leg so it is bent at a right angle, and gently tilt their head back to keep the airway open.
Should you observe severe bleeding, apply direct, firm pressure to the wound using a clean cloth or sterile dressing. Maintain continuous pressure on the wound to help control the blood flow until EMS arrives. If the cloth becomes soaked, add more layers on top rather than removing the original ones.
Common Reasons for Unresponsiveness
Unresponsiveness can stem from various medical conditions or external factors. Common causes include stroke, heart attack, severe allergic reactions (anaphylaxis), drug overdose, severe head injuries, diabetic emergencies (low or high blood sugar), and seizures. Only trained medical professionals can accurately diagnose the specific cause.
What to Expect When Help Arrives
When emergency medical services arrive, direct them clearly to the unresponsive person’s location. This helps them quickly assess the situation and begin advanced care. Provide a concise summary of what occurred, including what you observed and the actions you took.
Explain when you found the person, their initial state, and any changes you noticed. Inform the paramedics about any interventions you performed, such as initiating CPR or placing the person in the recovery position. Once paramedics take over, step back and allow them space to work. Stay available to answer any further questions they may have, as your observations can provide valuable information for their assessment and treatment.