unconsciousness.pptx

LOSS OF CONSCIOUS AND IT HAS DIFFERENT STAGES OF UNCONSCIOUSNESS

1. WELCOME!!

2. UNCONSCIOUSNESS MISS RAJOSI KHANRA M.Sc. Nursing 1st year

3. OBJECTIVES OF THIS TOPIC…. To list out the symptoms of unconsciousness To define consciousness and unconsciousness To explain levels of unconsciousness To tell about the complications of unconsciousness To describe etiology and pathology of unconsciousness To explain the management of an unconscious patient 01 04 02 05 03 06

4. CONSCIOUSNESS consciousness is a state of awareness of the outside of the world,of self own thought and feelings. The state of being aware, aware of both internal and external stimuli. The state of being aware of and responsive to one’s surroundings. The state of being characterised by sensation,emotion and mind.

5. UNCONSCIOUSNESS Unconsciousness is a state in which a patient is totally unaware of both self and external surroundings and unable to respond meaningfully to external stimuli. Periods of unconsciousness may be momentary or may last for month.

6. EXCITATORY SOMNOLENT STUPOR US COMA LEVELS OF UNCONSCIOUSNESS

7. SOMNOLENT UNCONSCIOUSNESS The patient is extremely drowsy and will respond only of spoken or touch. This response is rarely more than a mumble or a jerky body movement in response to a stimulus. EXCITATORY UNCONSCIOUSNESS The patient does not respond coherently but is easily disturbed by sensory stimuli such as bright lights, noise or sudden movement. They may become excited and agitated at the slightest disturbance . This type of unconsciousness is commonly seen in patients who are going under anaesthesia. In care of such patient the room should be kept dimly lighted, the environment should be quiet, talking should be avoided any necessary movement or activity should be slow and gentle. STUPOR US UNCONSCIOUSNESS It is a semiconscious state .Patient responds only to painful stimuli such as pricking or pinching of the skin. In deep stupor patient may respond only to suborbital or substernal response.

8. COMA Coma is a state of sustained unconscious in which the patient Does Not respond verbally Does not move voluntarily Does Not eye response Altered respiratory pattern

9. ETIOLOGY

10. METABOLIC DISORDERS ( impair the cerebrum and the arousal functions by decreasing the supply of oxygen) Diseases of neurons. Metabolic encephalopathy. Disease of other organs e.g. liver, kidney. Fluid and electrolyte imbalance. Infections. Nutritional deficiency. Hypoglycemia. Anoxia or ischemia. Common fainting. STRUCTURE LESIONS ( pressure on the brain stem ) upper brain stem dysfunction Brain Tumour. Brain abscess (rare). Cerebral haemorrhage. Cerebral infarction (large). Epidural hematoma/Subdural hematoma. Subtentorial lesions (compressing or destroying the reticular formation). Cerebellar abscess. Infarction. cerebellar haemorrhage/Tumour.

11. PSYCHOGENIC CAUSES Hysteria Catatonia OTHER CAUSES OF TEMPORARY UNCONSCIOUSNESS Low blood sugar Low blood pressure Dehydration Problems with heart rhythms Hyperventilation

12. PATHOPHYSIOLOGY Consciousness depends on intact cerebral hemisphere and RAS ↓ Exposure to etiological factor ↓ Damage to brain and skull(primary) ↓ Edema, inflammation and haemorrhage ( secondary injury) ↓ Increased ICP ↓ Diffuse damage to cerebrum, corpus callosum,brainstem ↓ Block the signals to RAS ↓ Unconsciousness

13. SYMPTOMS Confusion Drowsiness Disorientation Altered ocular movements and dilated pupil Inability to speak or move parts of his or her body Lightheadedness Loss of bowel or bladder control (incontinence) Rapid heartbeat (palpitations) Convulsion or seizures Stupor

14. WHEN TO SEEK MEDICAL CARE Has stopped breathing Does not regain consciousness quickly lie, within 5 minutes) Has been injured, especially if he/she is bleeding Has diabetes Pregnant Aged greater than 50 Experiences loss of blower control seizure If the person does not regain consciousness promptly contact emergency medical services Even if the person does regain consciousness promptly, a medical evaluation should be given to rule out a serious underlying problem.

15. DIAGNOSTIC ASSESSMENT Glasgow coma scale Magnetic resonance imaging (MRI) Computed tomographic (CT) scan Lumbar Puncture Electroencephalogram (EEG)

16. PRESSURE SORE ASPIRATION PNEUMONIA ANOXIA PERMANENT INITIAL BRAIN DAMAGE COMPLICATIONS

17. FIRST AID Call or tell someone to call ambulance. Check the person's airway, breathing, and pulse frequently. If necessary, begin rescue breathing and cardiopulmonary resuscitation. If the person is breathing and lying on the back, and you do not think there is a spinal injury, carefully roll the person toward you onto the side. Bend the top leg so both hip and knee are at right angles. Gently till the head back to keep the airway open. If breathing or pulse stops at any time,roll the person on to his back and begin CPR. If you think there is a spinal injury,leave the person as found. If the person vomits,roll the entire body at one time to side.support the neck and back to keep head and body in the same position while rolling. Keep the person warm until medical help arrives. If you see a person fainting , try to prevent a fall. Lay the person flat on floor and raise the feet. If fainting is likely due to low blood sugar, give the person something sweet to eat or drink when consciousness returns.

18. MEDICAL MANAGEMENT Patient's airway and circulation must be maintained. Hyperventilation is an effective way to reduce cerebral blood flow when coma is due to bleeding. Circulation is maintained by monitoring blood pressure. Assess the depth of consciousness by observing responses to stimuli and responses. Assess pupil sizes and reactivity to light. Assess evidence of trauma. Determination of serum glucose level. Thiamine is commonly given because many comatose patients are malnourished. If patient is having repetitive seizures, the patient is given intravenous diazepam to stop seizures. Cultures are taken of blood,nose,throat. once the cultures are taken, antibiotics are given to combat any infection.

19. NURSING MANAGEMENT Airway management of unconscious patient Positioning Airway adjuncts Airway clearance Eye care Providing sufficient nutrition Care for urinary bladder Care for bowel management

20. CONCLUSION Unconsciousness is a state in which a person is unable to maintain an awareness of self and environment. It may occur as a result of traumatic brain injury, brain hypoxia, severe drug intoxication which depresses CNS. Nurses provide a lifeline for patients giving proper care, protection and promoting normal body function.

21. THANK YOU!!!!!