Consciousness is the state of being aware of or responsive to the environment. A person who is conscious can perceive, both physically and mentally, what is happening. For many reasons, a person can sometimes lose consciousness, or become unconscious.
An unconscious person generally seems to be sleeping. However, being unconscious is different from being asleep. A person can usually, but not always, be roused from the unconscious state.
There are many causes of unconsciousness, including:
The only consistent sign of loss of consciousness is that the person is no longer aware of, or responsive to, his or her surroundings. A person who is unconscious does not appear to respond to sound or touch. Many times, the person quickly regains awareness, similar to "waking up" after fainting. In more serious situations such as a severe head injury, a person may remain unconscious for a long period of time. A coma, which is a state of unconsciousness from which a person cannot be aroused, may last for hours, days, or even years.
Other signs and symptoms are related to the specific cause of the condition. For example, an individual who loses consciousness as a result of a head injury may have a bump on the head or a bleeding wound.
Diagnosis of the cause of loss of consciousness begins with a medical history and physical exam. In many cases, further tests are needed to help determine the reason for this condition, including:
Prevention of unconsciousness is related to its underlying cause. For example, avoiding drug use can prevent cases resulting from overdose. Proper treatment of diabetes can prevent many cases due to this disease. Many head injuries can be avoided by following sports safety guidelines for children, adolescents, and adults. Many cases cannot be prevented.
More than half the time, a loss of consciousness is due to simple fainting. Usually, this has no long-term effects. Some people who faint may injure themselves as they fall to the floor.
If the unconsciousness is due to a more serious cause, the long-term effects may be severe. For example, head injuries and strokes can result in permanent brain damage, disability, or death.
A loss of consciousness itself is not contagious. If the loss of consciousness is due to an infection such as meningitis, the infection itself can be contagious.
Often, treatment is not needed for a simple loss of consciousness because the person usually returns to normal within a few minutes. A person who faints should be positioned on his or her back. The nearest witness who feels comfortable doing so should check the person's airway and breathing.
If the person remains unconscious, first aid for unconsciousness should be given:
At the hospital, the medical team will try to maintain basic vital functions, such as breathing and blood pressure. The person may need a ventilator, or artificial breathing machine, or medications to maintain blood circulation. Oxygen, intravenous (IV) fluids, and close monitoring of the person are done routinely.
Further treatment is directed at the cause of the loss of consciousness. For example, glucose, a form of sugar, may be given to a person who has low blood sugar. If a heroin overdose is the reason for unconsciousness, Naloxone can be given to reverse it. Someone with a subdural hematoma may need brain surgery. An individual with an infection may need antibiotics.
Side effects depend on the treatments used. For example, antibiotics may cause allergic reactions or stomach upset. Surgery carries a risk of bleeding, infection, and allergic reaction to the anesthesia.
After fainting, the individual usually needs no further treatment or monitoring. Further treatment may or may not be needed for other conditions. For example, a person with serious kidney disease, liver disease, or diabetes usually needs lifelong monitoring and treatment.
A person who faints may receive a few tests to make sure there is not a serious cause. He or she may be observed for a brief period and then sent home. Other monitoring can be used to diagnose the cause of the condition. Any new or worsening symptoms should be reported to the healthcare provider.
Author:Adam Brochert, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:11/29/00
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:07/12/01
Harrison's Principles of Internal Medicine, 1998, Fauci et al.