Fainting

1st Aid Response

*Call for help! *Lower the head to increase blood supply to the brain -if in bed: lower head of bed -if sitting: put head between legs -if lying down: elevate legs 8-12 inches; leave head flat *Loosen clothing, apply cool, wet towel to forehead *Turn to recovery position if vomiting or if there is a danger of choking because while unconscious they cant clear airway themselves *Do not shake or slap in attempt to make regain consciousness *if injured give appropriate 1st aid before recovery -apply direct pressure to bleeding *Check Vital signs; if abnormal *Attempt to keep from standing until fully recovered

At risk populations

*Elderly -major cause of morbidity &mortality *Pregnant-muscles surrounding the blood vessels relax often lowering the blood pressure *Sitting/lying down for long periods of time-blood pools in the leg veins resulting in postural hypotension elderly, diabetics, medications such as vasodilators/antihypertensives *heart disease or stroke-obstructed blood flow in the heart or irregular heart beat *Performers- stand on feet for long periods of time

Types of Syncopal Episodes

*Neurocaridogenic/vasovagal Sympathy: -usually harmless; does not require treatment -not usually related to a disease condition -most common cause of syncope *Environment: -Heat, oxygen level, posture, exerscise *Underlying Disease: -Readily identified; not yet diagnosed

Signs/symptoms

*Pale, clammy & sweaty *Dizziness *weakness *nausea *being cold *having blurred vision

Heart Disease Episodes

*Stoke-Adams Syndrome: -Blood to the brain temporarily inadequate due to arrhythmia *Hypertrophic Cardiomyopathy: -seen in younger athletes *Wolff-Parkinson-White Syndrome: -Abnormal extra electrical pathway to the heart causing tachycardia; most common cause of Tachycardia in infants and children -Seen on 12 lead EKG as short p-r interval *Heart Blocks -Causing inadequate blood to brain *Stroke

Cardiogenic or Vasovagal Syncope

*Vagus nerve stimulation causing excess acetylcholine release -sudden drop in heart rate &BP -Low blood level to brain *Occurs as body overreacts to these triggers -sight of blood;surgery;horror -pain -extreme emotional distress -excess straining with urination/bowel movement -excess coughing -playing a wind instrument

Underlying disease Episodes

-Diabetes -anemia -parkinson's -osteoarthiritis in the neck-pressure on blood vessels when neck is suddenly turned -medications-anxiety, depression, allergies, meds can cause drop in blood pressure -Hypoglycemia

Environmental Episodes

-fatigue -pain -dehydration -alcohol use -standing too still, too long -being in a poorly ventilated room w/o adequate oxygen -postural/orthostatic response-standing up too quickly -prolonged or excessive heat exposure

CALL 911! If:

-recovery doesnt occur within 1 minute -person is pregnant -over 50 yrs old - diabetic person -fainted and fell from a height - person is bleeding -feels chest discomfort -loss of speech, movement or vision -convulsions or loss of bladder/bowel control

Incidence & Prevalence

Common condition: - 3% ER visits -6% hospital admissions -30% will experience another syncopal episode

Syncope

Fainting; sudden, temporary loss of consciusness which occurs when the brain does not receive adequate blood supply -recovery is quick and episode is brief -loss of muscle control occurs during episode