Unconscious Casualty

This is a particularly difficult situation to deal with. The casualty's airway is always your first priority. The person may have a broken back that could cause nerve damage and paralysis, but you do not protect the airway and ensure that the casualty continues breathing, she will die.

First Aid Treatment

If you come across an unconscious person for whom the nature of the accident or the positioning indicates that she may have broken her back (for example, a bystander tells you the casualty fell, or the person is wearing motorcycle leathers and lying next to a damaged bike), your priority remains to check the airway.

1. Ask a question to find out if the casualty is conscious. Do not shake the casualty.
2. Carry out your ABC checks, taking care to tilt the head gently. If the head is already extended a suitable way, do not move it any further. lnstead, just use the chin lift and carefully check the mouth.
3. If the casualty is not breathing, give rescue breaths and full CPR as needed. Make an early call for an ambulance.
4. If you have to roll the casualty on to her back to resuscitate, then you should aim to keep the casualty's head, trunk and toes in a straight line. If possible, get bystanders to help move the casualty over, but do not waste time looking for help because the casualty needs air as soon as possible.
5. If the casualty is unconscious and lying in such a way that the head is extended and she is on her side, allowing fluid to drain from the mouth, then leave her alone.
6. Hold the casualty's head still by placing your hands over the ears and your fingers along the jawline. Ensure that the airway is monitored.
7. If the casualty is unconscious and either the head is not extended or she is not lying on her side, you need to move her into the recovery position. Ideally, with enough bystanders, you should use the log roll. lf not, be prepared to roll the casualty into the recovery position with all available help.