What is the next step if a woman collapses with loss of consciousness?

Management of Sudden Collapse with Loss of Consciousness

The most appropriate next step for a woman who suddenly collapsed with loss of consciousness is to call 911 (activate emergency response system) immediately. 1

Initial Assessment Algorithm

When encountering a person who has suddenly collapsed with loss of consciousness:

1. Ensure scene safety - Make sure there are no hazards to yourself or the victim
2. Check responsiveness - Tap the victim's shoulder and shout "Are you all right?"
3. If unresponsive:
   • Activate emergency response system (call 911) immediately 1
   • Get an AED if available or send someone to retrieve one
   • Return to the victim to begin assessment and care

Rationale for Activating Emergency Response First

The 2020 American Heart Association guidelines clearly state that when finding an unresponsive adult, the first critical step is to activate the emergency response system 1. This prioritization is based on evidence showing that early professional intervention significantly improves survival outcomes.

For a lone rescuer finding an unresponsive victim:

• Immediate activation of emergency response ensures professional help is on the way
• The dispatcher can provide guidance for subsequent actions
• Early EMS arrival means earlier access to advanced life support and transport

Assessment After Activating Emergency Response

After calling 911, return to the victim and:

1. Check breathing and pulse simultaneously (take no more than 10 seconds)

2. If no normal breathing (only gasping) and no definite pulse:

   • Begin CPR with chest compressions at 30:2 ratio
   • Use AED as soon as available

3. If pulse is present but no normal breathing:

   • Provide rescue breathing (1 breath every 6 seconds)
   • Recheck pulse every 2 minutes

Common Pitfalls to Avoid

• Delaying emergency activation: Every minute delay in activating emergency response reduces survival chances
• Misinterpreting agonal gasps as normal breathing: These irregular, gasping breaths can occur in cardiac arrest and should not be confused with normal breathing 1
• Taking too long to check for pulse: Healthcare providers should take no more than 10 seconds to check for a pulse 1
• Moving the victim unnecessarily: Unless in immediate danger, the victim should be assessed and treated where they collapsed 1

Special Considerations

• Syncope (transient loss of consciousness) is common but can be associated with life-threatening conditions 2
• Even if the victim regains consciousness quickly, they should still receive medical evaluation as this could indicate serious underlying conditions 1, 3
• For elderly patients, presentation may be atypical and require more careful assessment 4

The evidence clearly supports that for a woman who has suddenly collapsed with loss of consciousness, the correct next step is to call 911 to activate emergency medical services, which will ensure prompt professional assessment and intervention.