Page 265 - ATP-P 11th Ed

LOSS OF CONSCIOUSNESS PROTOCOL
(WITHOUT SEIZURES)

SPECIAL CONSIDERATIONS
1. The most common cause of loss of consciousness in healthy adults is orthostatic
hypotension (associated with sudden standing) or vasovagal syncope (associated
with sudden adverse stimulus – injections are a common cause).
2. Also consider hypoglycemia, anaphylactic reaction, medication, recreational
drug use, head trauma, hyperthermia, hypothermia, myocardial infarction, light- SECTION 2
ning strikes, and intracranial bleeding.

Signs and Symptoms
Unconsciousness
Management
1. Follow BLS guidelines.
2. Management of orthostatic hypotension and vasovagal syncope is accomplished by
placing the patient in a supine position, ensuring the airway is open. Patients experienc-
ing these two disorders should regain consciousness within a few seconds. If they don’t,
consider other etiologies and proceed to the steps below.
3. Pulse oximetry monitoring.
4. Oxygen
5. Place either 1 tube oral glucose gel (Glutose ) OR 1 packet of sugar in buccal
™
mucosa.
6. Consider IV access.
7. Naloxone (Narcan ) 0.8mg IV/IM. Repeat q2–3min prn to max dose of 10mg if
®
opiate use is suspected.
8. If no response treat per appropriate Protocol per Special Considerations #2.

Disposition
1. Urgent evacuation, unless loss of consciousness due to orthostatic hypotension
or vasovagal hypotension.
2. The evacuation package should include personnel certified in Advanced Cardiac
Life Support (ACLS), with equipment, supplies and medications necessary for
ACLS care.

254 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 255