Keeping conscious when dying?

Factual Questions
21

I’m pretty sure we did this once before. The conclusion was that it was more so you could monitor the condition of the injured party.

22

“I put splints on all the broken bones. And look how neat all my bandages are!”

“Well, yes, but…he’s dead!”

“Oh. Sorry, I didn’t realize that was important.”

23

This made me laugh a lot more than any typo has any right to.

When I took a first-aid class in tenth grade they told us that the only thing keeping someone awake after a serious injury does is makes it easier to monitor for changes in how oriented they are. We were taught that that applies to any serious injury, not just head injuries, because a change in their mental status can also indicate the presence of something wrong that you can’t see (eg, internal bleeding).

ETA: From a ‘first responder’ point of view, I have no idea what you’re supposed to do if you do notice that change in mental status, but, uh, that’s all the Red Cross guy ever taught us.

24

Ok.
Do you know your ABCD (pdf)?

A-airway
B-breathing
C-circulation
D-disabillity.

Disability is partly measured by the Glasgow Coma Score. It is scored out of 15. 15 is perfectly coherent and alert , 3 is basically dead. 8 and below is unconsciousness to the point where the person can no longer protect their own airway.

By not opening eyes to command, not speaking at all and not squeezing a hand to your request, your patient immediately gets a GCS of 8 (E2,V1, M5) or less. At that point you need to protect their airway for them (jaw thrust, chin tilt) because they will not have the muscle tone to prevent their airway from becoming occluded by their tongue. Tongue in upper airway means that very soon there will be no breathing and no circulation and you’ll have a full cardiac arrest on your hands.

In real life I don’t shout at people to stay awake for me -brain damage is brain damage, and blood loss and hypoxia are blood loss and hypoxia- if they are going to pass out, they’re going to pass out. I just need to recognise when they do go unconscious, so that I can take steps to ensure that they don’t die.