You’ve seen it in movies (and hopefully not in real life) – the hero is pulled from the flaming wreck/burning house/water and valiant rescuers battle to “keep him with us” or “keep them awake”- but why exactly do people think it’s necessary to keep someone conscious?
We hear it in class often enough – “Do I need to keep them awake?”
Well, there are two reasons why it benefits a conscious person to stay that way:

1 They can protect their own airway.

If you’ve been to class you know the importance of this one. We’ve talked about the dangers of being unconscious on your back, we’ve practised rolling people over using the H.A.IN.E.S recovery position. We mention that unconscious people are likely to vomit.
By keeping them conscious (‘keep them awake’), they remain

  • able to continue breathing,
  • won’t choke on their tongue,
  • won’t (normally) aspirate,
  • won’t choke on their own vomit/blood/etc.

Generally, it’s less work for you and better for them if they remain breathing!

2. It helps them ‘fight’

This is a much more obscure reason to ‘keep them awake’ from a first aid point of view! While they remain conscious, they are (unconsciously) better able to maintain control of the assorted hormones & chemical messengers in the blood – adrenaline is the one you’re most likely to have heard of.
These help the person in stressful ‘fight or flight’ situations. It helps the person to ‘keep fighting’ – once they become unconscious there is often a sudden drop in blood pressure, which isn’t ever good for them and may possibly be fatal.

Sleep cat

Could you ‘keep him awake’?

Can you ‘keep them’ awake?

No, not really. This will depend on their injuries. You may be able to prolong it a little by talking to them. As far as first aid training goes, we don’t encourage slapping them to keep them ‘with us’ – not even a little bit: you should have other things to do that will be more helpful to the injured person!
Related topic: Head injuries – Should you wake them up? No, you don’t need to.
Credit: to NY Times for reminding me of point 2, and so making me write this post!