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Emergency departments and intensive care

Approaches may differ between hospitals but as a guide: Should you be admitted unconscious to a hospital Emergency Departments (ED), medical staff follow a systematic approach to assess and stabilise you.

Initial assessment (triage)
When you arrive unconscious, you are prioritised based on the severity of your condition. The ED team will quickly assess your airway, breathing, and circulation (known as the ABCs of emergency care) to ensure you are in a stable condition.

Airway management
Ensuring that a person's airway is clear is a priority. If necessary, the ED team may perform procedures including intubation (inserting a tube to help with breathing).

Breathing and circulation
Your breathing and heart rate are monitored. Oxygen may be administered to ensure proper oxygen levels. If your blood pressure or heart rate is abnormal, interventions may be given, eg: fluids, medication.

Vital signs and monitoring
A range of tests are performed to gather information on vital signs, including temperature, heart rate, respiratory rate, and blood oxygen levels. Blood samples may be taken for laboratory tests to check for issues like low blood sugar, electrolyte imbalances, or signs of infection or overdose.

Causes of unconsciousness (diagnosis)
A primary concern for the ED team will be to determine the reason for the admission and cause of unconsciousness. This may include scans, x-rays, electrocardiogram (ECG), bloodwork's and/ or urine tests.

Treatment and stabilisation
Based on the diagnosis, treatment will be initiated immediately. For example: If an overdose is suspected, antidotes may be administered. If there is a severe drop in blood sugar (hypoglycaemia), glucose may be given. For head injuries, specific treatments may be used, such as medications to reduce brain swelling or surgery if needed.

Intensive care or observation
If you are stabilised but still unconscious, you may be transferred to an intensive care unit (ICU) for closer monitoring. If you regain consciousness, the ED team will continue to monitor and assess your condition to ensure recovery. You may be discharged with a few hours, or the following morning.

Family, chosen family, notification and consent
Your medical next of kin is someone you nominate to receive information about your medical care—especially if you’re ill, unconscious, or unable to communicate. They are the person the hospital will contact in emergencies or if important updates are needed. “Next of kin” refers to the closest living relative(s) of a person. Contrary to popular belief, the term ‘Next of Kin’ has no legal standing in the UK. This is separate from an inheritance next of kin which is not covered here.

LGBT+ people may not necessarily have family or next of kin with whom they would want ED staff to contact. The most significant relationships and support systems for LGBT+ people are often close friends and chosen family who are often excluded. This content has been prompted by gay men being admitted to Emergency Departments (A&E) from chems related overdoses and their chosen family being excluded.