Someone who is unconscious is not asleep. Unconsciousness is caused by illness, injury or emotional shock.


Signs and Symptoms:

There are many levels of unconsciousness. Some are more serious than others. Levels include episodes that are:

  • Brief: Examples are fainting or blacking out.
  • Longer: The patient is incoherent when roused.
  • Prolonged: A person in a coma, for example, can be motionless and not at all aware of his or her surroundings for a long time.


It may vary in depth from deep unconsciousness when no response can be obtained, through to lesser degrees of unconsciousness when the patient can be roused by speech or painful stimuli. [Source: Baillieres Nurses Dictionary: 23rd Edition page 405].


We measure the patient's level of consciousness by using the acronym 'AVPU':


  • A = Alert: The patient is fully alert and is able to answer questions clearly.
  • V = Voice: Confused, inappropriate words, utter sounds, no verbal response, not responding to speech.
  • P = Pain: Responds to painful stimuli or no response.
  • U = Unconscious: No response from patient.



There are 10 primary causes that can have an effect on a patient. They can easily be remembered by using the mnemonic 'FISH SHAPED':


  • F = Fainting
  • I  = Imbalance of heat
  • S = Shock
  • H = Head Injury


  • S = Stroke
  • H = Heart Attack
  • A = Asphyxia
  • P = Poisoning
  • E = Epilepsy
  • D = Diabetes


Management of The Unconscious Patient

An unconscious patient is unable to give an account of what has happened to them. Try and gain as much history from those at the scene and from any injuries sustained as to what may have happened.



  • Never leave an unconscious patient unattended other than to get help or dial 999.
  • Maintain a good airway at ALL times.
  • Constant monitoring patient has a good airway.
  • Carry out a Primary & Secondary Survey.



We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.


You might also be interested in this blog post about 'How to recognise a seizure'.


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