Does It Help an Injured Person if You Shout “Stay With Me!”

Answers to your questions about the news.
Jan. 26 2014 11:43 PM

Stay With Me!

The Explainer Question of the Year: Does shouting at an injured person have any medical benefit?

Last month the Explainer paused while packing up his things to ask if his faithful readers would help decide the final Question of the Year. Thousands of you sifted through the topics that this column was unable to address in 2013—a list of matters of minuscule importance, such as why venison is not usually made into soup, and when people started drinking beverages through straws. But these were just the also-rans. What were the runners-up?

Daniel Engber Daniel Engber

Daniel Engber is a columnist for Slate

In third place, with 8.1 percent of the votes, a question of meteorological anthropology: What did Native Americans think of tornadoes? This would have been a tricky one to answer, as some American Indians seemed to view them as a cleansing while others called them punishment.

In second place, with 8.7 percent, some cross-cultural lexicography: I love palindromes (“A man, a plan, a canal—Panama!”) but I’ve always had an English-centric view of them. What are some palindromes in other languages? What’s the easiest language for palindromes? Another question that doesn’t have an easy answer. As they say in Iceland, Amma sá Afa káfa af ákafa á Samma—“Grandma saw Grandpa enthusiastically groping Sammy.” Let’s leave it at that.


And in first place by a wide margin, with 12.3 percent of the votes, our Explainer Question of the Year for 2013: Countless times in TV shows or movies, characters urge a wounded figure to stay with them, not to lose consciousness. Is there any medical basis for this? Doesn’t the body need to lose consciousness to cope with the emergency? Might these dramatic and good-hearted souls actually hasten the wounded character’s death?

The answer: No, no, and no. If someone’s about to fall into a coma, there’s nothing you can say to change his mind.

It may seem like unconsciousness would be a first step toward death, but that’s not really true. As a general rule, whatever underlying problem causes a loss of consciousness—whether it’s a stroke, a drug overdose, blood loss, or something else—will continue to unfold irrespective of a patient’s state of awareness. Keep him awake or let him sleep; it doesn’t matter much.

An unresponsive patient may face some special risks, however. The muscles of the airway can relax in such a way as to hinder breathing, or a patient might be suffocated by his floppy tongue, or by having his neck tilted at a funny angle. ER doctors and technicians are trained to keep a victim’s airway clear. They may do this by inserting a tube into the trachea. They don’t do this by slapping a victim across the face or begging him to stay alert.

It’s often said that those who suffer head injuries should be kept awake by whatever means necessary, on the theory that dozing off could send them into a coma. Most doctors say that’s not the case at all. It might still be a good idea to rouse a patient from time to time and make sure that she’s still OK. When people are asleep, they have no clear way to register distress, so waking them periodically may be a useful way for those around them to know if things are getting worse.

Even if it were a good idea to keep a patient from losing consciousness, it’s not clear how that could be accomplished. Spoken pleas won’t have a significant effect, nor will you gain much ground by calling your loved one a “bitch” and telling her to "fight, goddammit, fight!" (See the video clip below.) Other, more aggressive forms of stimulation might work a little better. When an ER doctor slides a tube into a wounded patient’s trachea, her eyes might snap open for second, and her breathing could be restored. But so far as doctors know, the jolt wouldn’t last.

The only time that yelling might be useful is when doctors suspect that a patient might be faking, or that he is the victim of a psychogenic coma. If he responds to a loud noise, then he’s not really unconscious.

“Stay with me” does make for dramatic scenes in movies, though, science notwithstanding. In 2006, a pair of researchers in neurology at the Mayo Clinic reviewed several dozen Hollywood films going back to 1970 to see how comas were portrayed. They found numerous inaccuracies, including what they called the “Sleeping Beauty phenomenon”: Patients appeared to be sleeping peacefully, with their eyes closed and otherwise in good health. (In real life, comatose patients often have a feeding tube or tracheotomy, as well as permanent muscular contractions that can make the body look deformed.) Of the movies they considered, just 7 percent gave a “reasonably accurate presentation of prolonged coma.”

Got a question about today's news? Ask the Explainer.

Explainer thanks J. Stephen Huff of the University of Virginia School of Medicine and Leigh Vinocur of the Lousiana State University Health Science Center.

Previous Questions of the Year:

2012: Why do the rich and famous always sunbathe topless?

2011: Why are smart people usually ugly?

2010: Why do boys like sticks?

2009: If a Siamese twin commits murder, does his brother get punished, too?

2008: What is the most disloyal dog breed?

2007: Why don't we drop medical waste and nuclear waste into active volcanoes, the "ultimate high-temperature incinerators"?

2006: Can a bar of soap get dirty, or is it self-cleaning because it's soap?

Daniel Engber is a columnist for Slate



Slate Plus Early Read: The Self-Made Man

The story of America’s most pliable, pernicious, irrepressible myth.

Rehtaeh Parsons Was the Most Famous Victim in Canada. Now, Journalists Can’t Even Say Her Name.

Mitt Romney May Be Weighing a 2016 Run. That Would Be a Big Mistake.

Amazing Photos From Hong Kong’s Umbrella Revolution

Transparent Is the Fall’s Only Great New Show

The XX Factor

Rehtaeh Parsons Was the Most Famous Victim in Canada

Now, journalists can't even say her name.


Lena Dunham, the Book

More shtick than honesty in Not That Kind of Girl.

What a Juicy New Book About Diane Sawyer and Katie Couric Fails to Tell Us About the TV News Business

Does Your Child Have Sluggish Cognitive Tempo? Or Is That Just a Disorder Made Up to Scare You?

  News & Politics
Sept. 29 2014 11:45 PM The Self-Made Man The story of America’s most pliable, pernicious, irrepressible myth.
Sept. 29 2014 7:01 PM We May Never Know If Larry Ellison Flew a Fighter Jet Under the Golden Gate Bridge
Dear Prudence
Sept. 29 2014 3:10 PM The Lonely Teetotaler Prudie counsels a letter writer who doesn’t drink alcohol—and is constantly harassed by others for it.
  Double X
Sept. 29 2014 11:43 PM Lena Dunham, the Book More shtick than honesty in Not That Kind of Girl.
  Slate Plus
Slate Fare
Sept. 29 2014 8:45 AM Slate Isn’t Too Liberal, but … What readers said about the magazine’s bias and balance.
Brow Beat
Sept. 29 2014 9:06 PM Paul Thomas Anderson’s Inherent Vice Looks Like a Comic Masterpiece
Future Tense
Sept. 29 2014 11:56 PM Innovation Starvation, the Next Generation Humankind has lots of great ideas for the future. We need people to carry them out.
  Health & Science
Medical Examiner
Sept. 29 2014 11:32 PM The Daydream Disorder Is sluggish cognitive tempo a disease or disease mongering?
Sports Nut
Sept. 28 2014 8:30 PM NFL Players Die Young. Or Maybe They Live Long Lives. Why it’s so hard to pin down the effects of football on players’ lives.