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How To Respond When a Patient is Unconscious: What Do the ACLS Guidelines Teach Us?

In any emergency situation, quick assessment of an individual’s injury or illness can save a life. When this individual is conscious and can communicate, performing lifesaving actions can be guided by his or her descriptions of pain or discomfort. But what do you do when the patient is unconscious and unable to respond to you?

Completing several patient assessments – as dictated by the ACLS guidelines – may be necessary before effective and adequate care can be provided to a patient.

‘Victim assessments’ help direct the best method of care

During a primary survey of the patient, it’s important to actively complete a ‘victim assessment’ to determine responsiveness. If the patient exhibits poor respiratory efforts during this assessment, it often suggests that he or she is only semi-conscious or even fully unconscious.

Begin the ‘victim assessment’ by lifting the patient’s jaw to help open the airway and watch to see if the patient’s chest rises and falls with his or her own respirations. If the chest doesn’t make any movements and there is no evidence of breathing, begin with two rescue breaths.

In the case where two rescue breaths aren’t enough to spur an unconscious patient’s own respirations, there may be an immediate need to use an automatic external defibrillator (AED) to help the patient regain a normal heart rhythm and pulse.

The ACLS secondary survey advises a first responder to evaluate a patient’s “ABCDs”: airway, breathing, circulation and differential diagnosis, throughout the resuscitation.

Both surveys provide immediate indications for securing and protecting the patient’s airway and providing effective ventilation with supplemental oxygen, which are critical components of a successful resuscitation.


According to the ACLS guidelines, effective management of an unresponsive patient requires ongoing assessment and reassessment through the primary and secondary surveys. With a keen understanding of these two evaluations, they can be achieved and repeated in seconds. This offers insurmountable support to the immediate needs of the unconscious patient.

Health Ed Solutions offers a number of courses for first responders and others who require certification or want to be prepared for a medical emergency. For more information about ACLS certification or to learn PALS’ guide to caring for an unconscious patient or the BLS guidelines for managing care of an unconscious patient, click here.