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When someone collapses or becomes unresponsive, it can sometimes be challenging to ascertain if they are still living. Although witnessing a potential death can be alarming and upsetting, attempt to remain calm. If you assess that it is safe to approach the individual, endeavor to determine their responsiveness and breathing patterns. If not, contact emergency services and commence CPR. If there is suspicion of the individual being deceased, you can also look for indicators such as absence of respiration or pulse, unresponsive pupils, and loss of control over bladder and bowel functions.
Procedures
Administering Initial Aid
Assess potential hazards before taking action. Prior to approaching an individual who has collapsed or lost consciousness, swiftly evaluate the surroundings to determine if it is safe to do so. For instance, inspect the area for potential dangers like exposed electrical wiring, fire, smoke, or toxic fumes. Refrain from attempting to make contact or get close to the person if you believe it may jeopardize your safety.
- Exercise caution if you suspect the individual may be intoxicated or under the influence of drugs, as they could exhibit violent reactions if disturbed.
- If you deem it unsafe to approach, contact emergency services and provide details of the situation. Remain nearby until assistance arrives.
Pro Tip: If the individual is situated in a hazardous environment (such as a roadway), yet you believe you can safely approach them, endeavor to promptly but gently relocate them to a secure area.
Attempt to elicit a response from the individual. If you are confident in your ability to safely approach the individual, ascertain their level of consciousness. Use vocal prompts to capture their attention, including calling out their name if known. Additionally, consider gently shaking or tapping their shoulder.
- Inquire, “Are you okay?”
- An individual is deemed “unresponsive” if they exhibit no movement or reaction to external stimuli such as noise, touch, or strong odors.
- If feasible, enlist the support of another individual. This may involve delegating the emergency call or seeking aid while you remain with the individual and initiate CPR.
Assess the individual's airway by opening their mouth. Following the initiation of emergency response, carefully tilt the individual's head backward and inspect their oral cavity. Should you observe any fluid or foreign objects obstructing their airway, roll the individual onto their side and manually clear any obstructions from the back of their throat.
- If an obstruction persists despite your efforts, proceed with chest compressions. Such compressions can aid in dislodging materials obstructing the airway.
Check for indications of respiration. Subsequent to evaluating the airway, assess the individual's breathing patterns. Initially, observe if the individual's chest rises and falls. In the absence of visible chest movements, position your ear near their mouth and nose. Listen for breathing sounds and detect airflow against your cheek for a minimum of 10 seconds.
- If the individual exhibits gasping, choking, or irregular breathing, they are alive but not breathing normally.
- In the event of absent or abnormal breathing, CPR is necessary.
Initiate CPR if the individual is not breathing or if their breathing is irregular. Place the individual on a flat surface and position yourself beside their neck and shoulders. Next, assess their pulse for 5-10 seconds. If no pulse is detected, position one hand on the center of their chest, between the nipples, with the heel of your hand, and place your other hand on top. Maintain locked elbows and align your shoulders directly above your hands. Use your upper body weight to compress the chest 30 times, followed by 2 breaths. Repeat this cycle 5 times, then reassess their pulse.
- If you are not trained in CPR, focus on chest compressions only (hands-only CPR).
- If a pulse is present, administer rescue breaths exclusively. Provide 10 rescue breaths per minute and check the pulse every 2 minutes.
- Aim to compress the chest to a depth of 2 to 2.4 inches (5.1 to 6.1 cm). Strive for 100-120 compressions per minute.
- Continue chest compressions until assistance arrives or the individual begins breathing and moving independently.
- If CPR is within your skill set, assess the individual's airway after every 30 chest compressions and administer 2 rescue breaths before resuming compressions.
Detecting Signs of Deceased
Search for absence of pulse and breathing. The absence of a pulse (heartbeat) and respiration (breathing) are two of the most apparent indicators of death. If you suspect someone has passed away, start by examining these vital signs. However, note that determining whether an individual's heartbeat and breathing have ceased without medical equipment can be challenging.
- Remember to visually inspect, listen for, and feel for signs of breathing.
- To check for a pulse, elevate the person's chin and palpate their Adam's apple (or larynx). Then, insert your fingers into the groove between the Adam's apple and the large tendons on either side of the neck. A rhythmic pulsation should be perceptible beneath your fingers if the person has a pulse.
Examine for inaudible blood pressure if equipped with a cuff and stethoscope. If a stethoscope and blood pressure cuff are available, you can also listen for the sound of the individual's systolic blood pressure. Position the cuff on their arm just above the elbow and inflate it until it exceeds 180 mm Hg. Place the stethoscope beneath the cuff's edge inside the bend of their elbow. Gradually release the cuff's air while listening for the sound of a pulse as blood flows back into the arm's artery.
- If the sound of blood flow into the artery is not audible after releasing the cuff, the individual may have succumbed.
Caution: In situations where an individual unexpectedly collapses or ceases breathing, forego the assessment of blood pressure or other signs of death. Focus on administering CPR until medical assistance arrives. Assessing signs of death is more appropriate in scenarios where death is anticipated, such as providing care for someone in the terminal stages of a terminal illness.
Check for still and dilated eyes. Gently open one of the individual's eyes (if not already open). If the individual has passed away, you will observe no movement in the eyes. If a flashlight is available, illuminate their eyes to observe pupil constriction. Following death, the pupils typically remain open and dilated even when exposed to bright light.
- It's important to note that unresponsive pupils can also be caused by factors like certain medications or nerve damage affecting pupil and eye movement. Do not presume death unless accompanied by other indicators such as absence of breathing or pulse.
Observe for loss of bladder and bowel control. Upon death, the muscles controlling bladder and bowel function relax. If the individual experiences sudden urination or defecation, it may signify death.
- Sudden incontinence may also indicate other conditions such as nerve damage or stroke.
Pointers
Cautions
- The only way to confirm an individual's death is through an official diagnosis from a medical professional. Refrain from assuming death solely based on the absence of obvious signs of life.
