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What indicates that a casualty is unresponsive when checking levels of consciousness?

  1. They react to loud sounds

  2. They no longer follow simple commands

  3. They do not respond to pain or voice

  4. They exhibit rapid eye movement

The correct answer is: They do not respond to pain or voice

The indication that a casualty is unresponsive is primarily observed when they do not respond to pain or voice. In a medical context, an unresponsive person would not react to stimuli that typically provoke a response, such as verbal prompts or physical pain (like a gentle pinch). This lack of reaction is a clear indicator of a reduced level of consciousness and suggests the need for immediate medical attention. When a person is unresponsive, they will not show any signs of awareness or engagement with their environment, which is critical for assessing their condition. Responses to loud sounds, following simple commands, or exhibiting rapid eye movement may suggest varying levels of responsiveness or altered states of consciousness, but they do not confirm unresponsiveness. Therefore, the absence of response to both pain and voice is the definitive sign you're looking for in this context.