Medical First Aid Guide


Table 4: CHEMICAL-INDUCED DISTURBANCES OF CONSCIOUSNESS

Chemicals, whether inhaled, ingested or absorbed through the skin, can either depress or excite the brain. In cases of severe poisoning, the casualty may not only be unconscious but breathing may also be depressed or absent. Fortunately, in most cases, symptoms usually resolve rapidly when the casualty is removed from the polluted environment.

Signs and symptoms Treatment
Drowsy but breathing adequately
  • After removal of the casualty from the polluted environment, eye and skin decontamination should be undertaken, if necessary.
  • After decontamination the casualty should be observed in a place of safety for at least 8 hours. Usually no specific treatment is necessary.
Increasing loss of consciousness but breathing adequately
  • Place casualty in the recovery position. Recovery position
  • Remove any loose dentures.
  • Clean any vomit from the mouth and back of the throat.
  • Turn casualty face down, head to one side as pictured; no pillows should be used under the head.
  • Clear out any vomit in the mouth as soon as vomiting occurs.
  • The casualty must never be left alone or unwatched in case he vomits, has a fit or may fall out of his bunk.
  • Turn the casualty gently every 3 hours and roll him smoothly from one side to the other. Recovery position roll
  • The head must always be kept back with a chin-up position when actually turning, and, at no time must the head be allowed to bend forwards with the chin sagging.
  • If possible, insert a Guedel airway.
  • RADIO FOR MEDICAL ADVICE IN ALL CASES.
Unconsciousness with less than eight respirations of normal depth per minute
  • Place the casualty on his back.
  • Tilt the head firmly backwards with one hand while lifting the neck with the other hand to relieve obstructed breathing. Tilt head
  • Once a clear and open airway is established, insert a Guedel airway: see appendix 3. Guedel airway insertion
  • Administer controlled ventilation.
Further advice on controlled ventilation: see table 3.
  • Check for a pulse. The best pulse to feel in an emergency is the carotid. Feel for five seconds before deciding it is absent. If it cannot be felt or is feeble, there is insufficient circulation. Check for pulse
  • It should be felt after the first minute of artificial respiration and checked every 2 minutes thereafter.
  • If morphine has been administered: see table 13.
  • RADIO FOR MEDICAL ADVICE IN ALL CASES.
Prolonged coma with or without breathing difficulty
  • RADIO FOR MEDICAL ADVICE IN ALL CASES.
  • Regularly assess that breathing is adequate. Give ventilation support with 8 L of oxygen per minute if the victim does not breathe adequately.
Further advice on care of unconscious casualties: see appendix 4.
Toxic mental confusion (agitation, hallucinations)
  • If the casualty is difficult to manage, give diazepam 10 mg as rectal solution.
Further advice on treatment of agitation and hallucinations: see table 6.
Convulsions (seizures, fits)
  • Ensure that there are no hard or sharp objects in the vicinity so that the victim will not injure himself.
  • Give diazepam 10 mg as rectal solution.
  • RADIO FOR MEDICAL ADVICE.
  • If medical advice is unavailable and seizures continue, give a further 10 mg diazepam as rectal solution after 30 minutes.
Further advice on treatment of convulsions: see table 5.

Table 3: Oxygen administration and controller ventilation

Table 5: Chemical-induced convulsions (seizures, fits)