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A person may suddenly fall to the ground in a fainting fit or may be found lying unconscious on the road. Before any procedures can be started for bringing him back to consciousness, it is of vital importance to recognize the cause of the loss of consciousness. Unconsciousness may be due to the following reasons: (i) blood supply to the heart or the brain may be interrupted due to a disease; (ii) there may be injury to the brain; (iii) an attack of a nervous disorder like epilepsy or hysteria may render a person unconscious; (iv) poisons ingested deliberately, for the purpose of committing suicide, or mixed with food by someone with a criminal intent; (v) accumulation of toxins due to a failure of the kidneys can also lead to a state of unconsciousness; (vi) excessive loss of blood in an injury may be the cause of loss of consciousness; (vii) drowning, hanging or breathing of poisonous fumes, as in a sewer or in an airless room where charcoal has been burning for some time; and (viii) hyperparexia, i.e. high degree of fever (generally above 107oF.).

In the case of a fainting fit in the house, the history of the patient is generally known, but if a person found lying unconscious on the road, the following circumstances should be noted: (i) the position in which he is found lying; and (ii) the articles lying around him. If he has fallen from a height, say a tree, a ladder would normally be found. Hasty footsteps around a person with injuries may be the indication of his having been attacked . Tyre marks of a vehicle would normally indicate that he has been the victim of a hit-and-run driver. The smell of liquor around the unconscious person tells its story plainly.

But whatever may be the cause, steps should be initiated for bringing him back to consciousness. The legs of the victim should be straightened and the person laid comfortably on his back. All restricting clothing should be loosened. A flushed face may indicate that the blood is not flowing normally to the lower extremities and he should be laid in a position where the head is higher than the rest of the body. If his face is pale, the legs should be raised to allow the blood to flow to the heart and the brain. If there are signs of bleeding, steps should be taken to control it. Severe shock suffered as a result of the injuries can produce unconsciousness but it can be handles easily. The vital force of the body tries to assert itself and the injured person regains consciousness on his own. If, however, the loss of consciousness is due to damage to the brain or the heart, immediate medical attention should be sought.

In case of fainting fits, water should be sprinkled on the face of the unconscious person or smelling salts held under his nose. When an epileptic falls in a swoon, his restrictive clothing should be loosened and his head raised above the level of the rest of the body. A piece of cork or a handkerchief rolled into a ball should be thrust into his mouth so that the epileptic convulsions do not result in his biting his tongue. But the ball or the cork should not be too big, so that it does not interfere with the passage of air. The patient should be allowed to rest for some time and no effort should be made to break the fit. That would give him some rest. A similar procedure should be followed in the cases of hysterical fits.

When a person suffers from apoplexy he lies senseless without any signs of motion in any part of his body. If you lift his arm and then let it go, it will drop like a dead weight. His breathing is stertorous and sometimes too feeble to be noticed. His teeth are set, the extremities (hands and feet) cold, and the eyes insensitive to light. When all restrictive clothing has been loosened, his head should be bathed with cold water or an ice pack placed on it. Hot water bottles should be placed under his arm pits and he should be turned on his sides hourly till the arrival of the doctor.

When a person faints because of a heat stroke, his face and head should be bathed in cold water and he should be fanned. Dry leaves of Bengal Gram or chaff of that cereal should be steeped in water which should be used fro wiping the patient's body. White sandle wood rubbed in rose water should be applied on a boll of cotton which should be held under the patient's nose. When he regains consciousness, pulp of a raw mango roasted in hot ashes and mixed with sugar and water should be given to him to drink.

Unconsciousness may result if a person breathes poisonous air, as in a sewer or a well closed for a long time or in a room where charcoal has been burning for some time and the windows and the ventilators of which have been closed. If a person is found in a place where carbon dioxide is present-as in a room where a wood or charcoal stove has been burning-place a couple of kilo grammes of freshly slaked lime to absorb the poisonous gases. Take the person lying unconscious into the open air and lay him in a comfortable position. Sprinkle cold water over his face and chest. In case breathing has stopped, artificial respiration should be started as has been described in the section under drowning.

If the unconsciousness has been produced by drugs, e.g. opium or sedatives like sleeping pills, an entirely different procedure would have to be adopted. Too much of barbiturates would make a person drowsy and later totally unconscious. His breathing becomes stertorous and his breath may smell of the drug he has taken. The moment such a person is discovered, he should be aroused from sleep. Since he will not, of his own free will, he should be held by two person each of draping his arm over his shoulder. Water should be sprinkled over his head and chest. He should be given mustard ground fine and dissolved in lukewarm water. If he is unable to swallow, he should be given the mixture through a drenching tube. That would induce vomiting and some of the drug would be expelled from the stomach. If it is opium which is the cause of unconsciousness, two mashas of asafoetida dissolved in water would offset the effects of the drug. Another antidote of opium is permanganate of potassium, a general disinfectant. Four or five rattis of this substance should be dissolved in water (one glass full) and given to the patient to drink.

A similar procedure should be followed in cases where a poisonous substance has been willfully or accidentally ingested. Induce vomiting as described above and then take the patient to the nearest doctor. In case of barbiturates (the essential ingredient of sleeping pills), hot black coffee should be given to offset the sedative effects of the drug.


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