Doctor, My father has suddenly become unconscious since 4 hours. He is not talking and he is not moving the right hand and leg.

First assess whether the patient is critical (Deeply unconscious with Cheyne-Stoke’s breathing) or is hemodynamically stable.

If the patient is critical, ask for arrangements to shift to a hospital, and then proceed with a quick examination and first aid treatment.

Ask the history of onset in details: Whether it was gradual, sudden or catastrophic.

Was he known hypertensive or Diabetic?

First check the blood pressure, If it is too high> 200/ 120mm. then give 10mg Nifedepine from you emergency bag, sublingually immediately.

Ask the patient to lift the limbs. If he is unconscious, give a painful stimulus over the sternum, to observe the limb movements and then a painful stimulus over the supra-orbital ridge, to observe the facial movements.

Note whether it is total (dense) Hemoplegia, or is it Hemiparesis?

And is the facial ipsilateral or contralateral.

Palpate the both the carotid arteries in neck.

If one carotid is weaker, t suggests atherosclerosis or thrombosis.

Action:

Control the Blood pressure fast with sublingual Nifedipine.

Give IV hydergine or Nootropil and refer the patient to a physician.