Fainting, Its Cause and How to Relieve It - Apoplexy as Distinct from Compression - Concussion - Epileptic Fits - Convulsions and Hysteria and their Treatment - How to Transport the Injured with Safety

Various Forms of Insensibility - Their Causes and Treatment

A sufferer from poison may be discovered in an unconscious condition, and the treatment of such cases of insensibility has been discussed in sufficient detail for the purposes of first aid. Frequently persons become unconscious from some other cause, and when thus discovered, the helper should set to work to determine the method of procedure.

1. Fainting is by far the most common form of abnormal unconsciousness. It is due to the failure of the heart to send a sufficient supply of blood to the brain, and may arise from fright, debility, fatigue, hot, impure air, haemorrhage, or want of food. The face becomes pale, and a cold, clammy sweat forms on the forehead, the sensation is one of weakness and giddiness, until at last the patient loses consciousness and falls to the ground. At this point the willing helpers rush forward, but, unless they have been instructed to the contrary, they invariably do the wrong thing - i.e., raise the patient into a sitting position. The prostrate position of the patient is really Nature's attempt to readjust matters, for it is easy to see that vessels of the brain are more likely to receive a sufficient supply of blood if it simply flows along instead of having to be pumped up. The ease of flow is likewise increased if the head is on a lower level than the body. Accordingly, lay the patient perfectly flat, with the head on or below the level of the body. Loosen all tight garments, particularly round the neck, secure plenty of fresh air by opening the window if indoors, and by preventing persons crowding round if out of doors. Dash cold water over the face or spread a handkerchief soaked in eau-de-cologne over the forehead, and hold smelling salts to the nostrils (Fig. 1). As soon as consciousness returns give a stimulant, of which the safest is a teaspoonful of sal volatile in a wineglassful of water, but beware of attempting to force liquid into the mouth of an unconscious patient.

A person who feels the approach of faintness can generally prevent a total swoon by bending the head over until it rests between the knees, whence, after remaining still for a short time, it should be slowly raised.

2. Apoplexy shows an opposite condition of affairs. It usually occurs in stout, hearty people over sixty years of age, and is due to calcareous deposits rendering the blood-vessels so brittle that they cannot withstand the pressure of the extra work thrown upon them when the heart is stimulated to increased action by unwonted exercise. The symptoms of apoplexy are deep insensibility, loud snoring respiration known as stertorous breathing, flushed and congested face, thumping heart, and full pulse. The pupils of the eyes are unresponsive to light, and generally of unequal sizes, and the limbs of one side hang more limp and loosely than those of the other.

Let the patient lie flat, and in an easy, comfortable position, with the head slightly raised, but on no account with the chin resting on the chest. Undo all tight clothing, admit as much air to the patient as possible, apply cold water or ice to the head, and mustard leaves, mustard plasters, or hot-water bottles to the soles of the feet. When consciousness returns, avoid administering stimulants, particularly those of an alcoholic nature.

Fig. 1. In cases of fainting lay the patient flat upon the floor, with head on or below the level of the body. Loosen all tight garments, particularly round the neck, and place a handkerchief soaked in eau-de-cologne on the forehead

Sunstroke should be similarly treated, with the patient in the coolest available place; and if he seems to be in danger of dying, apply a mustard leaf to the nape of the neck.

3. Compression bears great resemblance to apoplexy, but may be distinguished from it by the absence of the full pulse and pumping heart. Compression may occur immediately after an accident owing to a portion of bone pressing on the brain, or with retarded symptoms when it is caused by a ruptured blood-vessel leading to an accumulation of blood, which presses on the brain. Move the patient with great care, and place him in a dark, quiet room, lying down with the head slightly raised. Loosen tight clothing, apply cold water or ice to the head, and avoid the administration of stimulants.

4. Concussion, or stunning, is caused by a fall or a blow, and varies in severity from

"seeing stars" to deep unconsciousness. In very severe cases the eyes do not respond to light or touch, and the breathing is so light as to be almost impercepti ble. When less severe, the patient can generally be roused momentarily from his apparent swoon, but appears dazed. All injuries of this class must be treated seriously. The patient must be kept quiet, and should not be allowed to resume mental work without a doctor's permission. Vomiting should always be regarded as a hopeful sign.

5. Epileptic Fits are disorders in which the patient falls with a shriek, followed by convulsions, during which he bites his tongue and cheeks. As soon as the paroxysm has passed away there is drowsiness, which should be followed by sleep.

In addition to the general treatment for insensibility, place a pad between the teeth. Make no attempt to check the movements, but control them so that there may be no injury.

6. Convulsions is a common complaint among young children when the nervous system is in an unstable condition. The hands are clenched over the thumb, the body stiffens, the eyes roll, and the lips become discoloured. Place the child in a bath of lukewarm water (980 Fahr.), and maintain this temperature (from ten to fifteen minutes if necessary) while the child remains in it. Sponge the face and head with cold water, and when the fit has passed off dry the child with hot towels, wrap him in a hot blanket, and guard him carefully against chill and excitement.