When encountering an individual who is unresponsive but still breathing, immediate, decisive action is required. Unresponsiveness means the person cannot be roused by verbal commands or physical stimulation, indicating a serious alteration in mental status. Although breathing suggests life-sustaining functions are active, this state can rapidly deteriorate. The primary goal is to maintain an open airway and prevent further harm until professional medical help arrives. This scenario is always a medical emergency, and quick action significantly influences the person’s outcome.
Secure the Scene and Call Emergency Services
Before approaching the person, rapidly assess the surrounding environment to ensure your safety and the safety of the individual. Hazards like traffic, unstable structures, or dangerous substances must be identified and avoided before any physical intervention. Securing your personal safety is paramount, as an injured rescuer cannot help.
Once the scene is safe, immediately contact emergency medical services (EMS). If a bystander is present, instruct them to call and stay on the line with the dispatcher while you begin first aid. The caller should be prepared to provide a precise location, the person’s age and sex, and a clear description of the situation, specifically noting that the person is unresponsive but breathing. They should also describe any visible injuries or symptoms and not hang up until the dispatcher advises them to do so.
Protecting the Airway: Using the Recovery Position
The greatest immediate danger for an unresponsive person lying on their back is airway obstruction. When consciousness is lost, the muscles relax, allowing the tongue to fall back and block the pharynx. Furthermore, the relaxed sphincter muscle at the stomach entrance increases the risk of passive regurgitation, where stomach contents can flow into the lungs, leading to aspiration.
To counteract this risk, the person must be placed into the recovery position, which keeps the airway open and allows fluids to drain safely from the mouth. Kneel beside the person and ensure both legs are straight. Take the arm nearest to you and place it out at a right angle to the body, bent at the elbow with the palm facing upward.
The arm farthest from you should be brought across the chest, placing the back of that hand against the cheek nearest to you. Next, bend the far leg at the knee so the foot is flat on the ground; this bent knee acts as a lever for the roll. While supporting the head with the hand pressed against the cheek, use the bent knee to gently roll the person onto their side, toward you. Once on their side, adjust the top leg so the hip and knee are bent at right angles for stability. Finally, tilt the head gently back to open the airway and ensure the mouth is angled downward so fluid can drain.
What to Monitor While Waiting for Help
Continuous monitoring of the person’s condition is necessary while awaiting the arrival of EMS. The observations you make are important data points that will be relayed to the paramedics upon their arrival. You must consistently observe the rate and quality of their breathing.
Watch for irregularities, such as shallow or labored breaths, or a change in rhythm. If breathing becomes noisy, irregular, or sounds like gasping, this is abnormal and requires immediate intervention, as it may signal a respiratory or cardiac event. Additionally, check the person’s skin color, particularly the lips and fingertips, as a bluish tint may indicate insufficient oxygenation.
Continue checking for any signs of returning consciousness, even if minimal, such as movement or sounds in response to verbal stimuli. If the person remains in the recovery position for an extended period, generally longer than 30 minutes, carefully roll them onto the opposite side to prevent prolonged pressure. If the person stops breathing or their breathing becomes severely abnormal at any point, be prepared to roll them onto their back and begin cardiopulmonary resuscitation (CPR).
Context: Why Might Someone Be Unresponsive But Breathing?
Unresponsiveness with preserved breathing can arise from a wide range of underlying medical events. These causes involve a temporary disruption of normal brain function, but not a complete failure of the brain stem centers that regulate breathing. Common categories include severe intoxication from substances like alcohol or opioids, which depress the central nervous system.
Metabolic emergencies are frequent causes, such as hypoglycemia, where low blood sugar levels starve the brain of necessary glucose. Head injuries, including concussions, can result in an altered mental state without immediate loss of breathing. A person may also be in a post-seizure (postictal) state, characterized by confusion and unresponsiveness after a convulsive episode. While these conditions provide context, the priority remains immediate first aid and securing professional medical assistance, not attempting a diagnosis.