First Aid Step 2 - Response

Have you ever thought if you came across someone with an altered conscious state you wouldn’t know the best way to get a response? 

We understand a person’s conscious levels as conscious (awake) or unconscious (asleep not being able to wake up). 

To understand what level of consciousness the casualty has, you want to follow AVPU: 

A – Alert 
The casualty is alert and responding normally to the questions I am asking.
V – Voice 
Is the casualty responding to my voice. How are they responding? What words are they using? Are they inappropriate, confusing or uttering words/sounds.
P – Pain 
Are they unconscious (asleep) and responding to pain or discomfort rather than my voice?
U – Unresponsive
They do not respond to anything you do. They do not respond to your voice or the pain they’re in.

There was this one time where I came across this casualty who was sitting up in a chair. As I approached them I could see they were awake however they did not look well. When I approached them, I offered my hand for a handshake (I did not shake or grip though) and said “Hi my name is Tom, I’m a first aider. Can I help you?” The casualty raised their hand slowly, shook my hand with a loose grip and gave me their name.

In doing this I could quickly asses their conscious levels by the response they gave me. Their response to the grip and shake of my hand and the response they gave verbally. I now had a baseline I could refer to. 

Today I want to share with you best practice of getting a response from a casualty who you might suspect is unconscious.

Response 

Ask the casualty the COWS questions in a loud voice: 

CAN YOU HEAR ME?
OPEN YOUR EYES?
WHATS YOUR NAME?
SQUEEZE (the casualty’s shoulders. Do not squeeze their hands)

If the casualty has a high response level (they are normal), make them comfortable and treat their injuries.

If the casualty has mid to low response levels (they are sleepy/tired, confused or dazed) place them in the Recovery Position and continue to monitor their conscious levels. This is where you can also apply first aid treatment to injured areas. 

If the casualty is unconscious, call Triple Zero (000) straight away and follow the operator’s instructions. Continue with Action Plan DRSABCD. 

Always monitor the casualty’s conscious levels so you are ready to act in the event they become unconscious. 

Remember, you are looking for any type of response, a movement, a spoken word or a noise. 

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