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Campus Health Service

Since it has happened that students/staff members collapse on campus, a need has been identified for you to be provided with information on the various reasons for collapse, and the course of action to take.

A. EPILEPSY

Background

This is a neurological disorder characterized by a recurrent pattern of abnormal neuronal discharge within the brain. This results in a sudden loss or disturbance of consciousness, sometimes in association with motor activity, sensory phenomena or inappropriate behaviour.

The seizure may be preceded by an aura a sensation peculiar for that patient and may be a visual disturbance, certain forms of dizziness or numbness, warning the patient of an impending seizure.

Causes

The cause may be unknown, appearing in childhood or adolescence, whereas epilepsy appearing in adulthood may be caused by head injury, stroke or brain tumour.

Management

  • Protect the patient from injuring him/ herself, but do not restrain the patient as this will make him/her more violent.
  • Check that the airway is open:
    • extend the neck
    • remove any obstruction
  • Do not put anything into the patient's mouth
  • Ensure patient's privacy
  • Assist if incontinent
  • Allow to sleep afterwards

B. CARDIAC ARREST

Background

Cardiac arrest is a sudden failure of the heart pump action and its consequent failure to maintain adequate circulation of blood to the body tissues. If bloodflow to the brain is not re-established within three minutes irreversible damage to brain cells will occur. Therefore prompt and effectiveaction is of vital importance.

Causes

Cardiac/respiratory arrest may be due to the following: ventricular fibrillation, cardiac standstill or circulatory collapse. Respiratory distress may also be caused by airway obstruction or respiratory depression, or it may be secondary to cardiac arrest.

Management

The management may be based on your prompt recognition of the four cardinal signs:

  • loss of consciousness
  • respiration absent
  • pulse absent(radial\carotid)
  • dilated pupils

Call for help and start CPR immediately following the ABC protocol:

A = Airway ensure the person's airway is cleared to allow air to enter the lungs. If he/she is breathing turn patient on his/ her side. If he/she is not breathing: Tilt the head backwards, lift the chin forward, place something under the shoulders.

B = Breathing check for breathing, look for chest movement. Listen and feel for air atthe nose and mouth. If no breathing, ventilate: Hold the airway open. Pinch the nostrils closed. Begin mouth-to-mouth ventilation. Seal your lips around the mouth, blow up the chest and watch it fall, at least 15 times per minute.

C=Circulation check for carotid or other pulse. Breathing patients have a pulse. Ventilate if there is a pulse, but no breathing.

Do CPR if there is no pulse nor breathing.

Cardio-Pulmonary resuscitation is filling the lungs with air, at the same time as compressing the sternum to squeeze the heart. You should see the chest rise and be able to feel a "pulse" during CPR.

By one person: Count 15 compressions then two breaths.

By two people: the person compressing should count aloud five presses then wait for one breath.

Keep going until the pulse returns.

C. SYNCOPE (FAINTING)

Background

Fainting is the sudden loss of consciousness. It is usually very brief and occurs with the person in the upright position.

Recovery is usually spontaneous.

In the case of Hypo\Hyperglycaemia the fainting attack occurs over a period of time. As the bloodsugar levels change, so the level of consciousness will also change.

Causes

  • Diabetes may cause a change in bloodsugar levels
  • Fainting due to: Vasovagal attack, due to stress, eg. when taking a patient's blood
  • Sudden drop in blood pressure
  • Pain and severe anaernia

Management

Call for help. If patient is a known diabetic inform medical help.

If patient has no known chronic illnesses, leave patient supine, may raise legs on a chair. Allow patient to wake up by himself/ herself, which should happen within two to three minutes. Do not hit patient in any way. Stay with patient until help arrives.

What should I do when a person collapses?

The question is always: How do you know what the cause and correct management are?

If you come across a person who has collapsed, the following would be a good course of action:

  • Stay calm, call for help,
  • Observe if person is breathing and has a pulse, if either is or both are absent, follow management under B.
  • If person is known to be an epileptic or has jerky movements follow management under A.
  • If the person is breathing, has a pulse, and jerky movements are absent, follow management under C.