This lesson focuses on what to do when you come upon a patient who has just fainted.
Fainting is defined as a temporary loss of consciousness that's usually related to temporary insufficient blood flow to the brain. Fainting is also referred to as syncope, blacking out, or passing out.
There are a number of reasons why a person would pass out and many of those are not at all life-threatening. In fact, when someone faints, the biggest concern is usually the victim's inability to protect themselves as they're falling, which can lead to a number of things going wrong – broken bones, head or face injuries, etc.
In many fainting situations, there is no one around who witnessed the accident. Which means you may need to put on your detective hat to properly discover potential injuries.
How to Assess and Treat a Patient who Faints
As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim.
"Hi, my name's _____. I'm a paramedic. I'm going to help you."
Pro Tip #1: The first thing you'll want to do is to assess for life-threatening conditions, including head and neck injuries. After ruling out more serious conditions, begin to see if the patient has a simple problem, like low blood sugar or dehydration that contributed to his or her passing out.
When you come upon a fainting victim, as long as there is nothing more serious going on, they will likely be awake and responsive. They may be sitting up already or are ready to sit up with your help. At this point you'll want to interview the patient to see what's going on.
"Can you tell me what happened here today?"
"Do you hurt anywhere?"
It's common for fainting victims to be weak and dizzy afterward. The important thing is that the patient is awake and responsive enough to answer your questions. However, continue to monitor for:
- Airway issues
- Breathing problems
- Weak or rapid pulse
- Pale, clammy skin
Pale and clammy skin are signs of shock. If you determine the patient to be in shock, that warrants an immediate 911 call and activation of EMS. As always, err on the side of patient welfare.
Pro Tip #2: Just because the situation doesn't appear serious doesn't mean it can't suddenly become serious. If you don't have an AED already, it's a good idea to send someone at the scene to go find one. If, for instance, the fainting was caused by a serious heart dysrhythmia, an AED could be lifesaving.
It's typical for fainting victims to begin to recover under their own powers. As they are coming around, gauge their mental alertness, ask again about the presence of pain, and of course, continue to assess for signs of something more serious:
- Decreased level of consciousness
- Airway, breathing, or circulation problems
- Signs of shock
- Long-bone fractures
- Varying degrees of responsiveness
If you, at any point, notice any of the above, call 911 and activate EMS or call in a code if you're in a healthcare setting. Then treat the patient accordingly.
A Word About Syncope and Presyncope
Syncope, or fainting, is caused due to a temporary reduction in blood flow to the brain. Depriving the brain of its normal blood flow can cause it to momentarily shut down. When this happens, it triggers a fainting episode or syncope.
But what specifically triggers fainting? There are a number of things that trigger it, including:
- Emotional shock
- Pain
- Certain medical conditions
- Overexertion
- In pregnant women and older people – getting up from a seated or lying position
Syncope can occur without warning. Or there could be some early signs, such as dizziness, the feeling of being lightheaded, or feeling like your about to faint. Together, these symptoms have a name – presyncope.
How to Prevent Someone in Presyncope from Fainting
- Help the patient lay down.
- Continue to monitor the patient's breathing and level of consciousness.
- Instruct and help the patient perform physical counter-pressure maneuvers (PCM).
Three Examples of Physical Counter-Pressure Maneuvers
- Have the patient grip one hand at the fingers with the other and try to pull them apart without letting go. They should hold the grip for as long as they can or until their symptoms disappear.
- Have the patient hold a rubber ball or similar object in their dominant hand and then squeeze the object for as long as they can or until their symptoms disappear.
- Have the patient cross one leg over the other and squeeze them together tightly. Have them hold this position for as long as they can or until their symptoms disappear.
Physical counter-pressure maneuvers help raise the patient's blood pressure through skeletal muscle contraction and, in many cases, will resolve symptoms of faintness.
Let the patient know to avoid holding their breath while performing the maneuvers. An easy way to avoid this is to engage the patient and keep him or her talking.