This is usually transient and totally reversible, although it may be serious (as when it follows a cardiac infarct). The cause is a sudden fall in the heart’s output, and the brain is temporarily deprived of blood and oxygen, so that it cannot operate effectively. Simple fainting (technically termed vasovagal syncope) is seen commonly. The person is usually standing upright and is overcome by a feeling of faintness, becomes pale, sweats, tends to breathe more rapidly, then suddenly loses consciousness. Unless supported, the patient will fall.
Fainting is more common in hot, stuffy, poorly ventilated rooms, during bouts of ill health, or when convalescing from sickness. Psychological factors may play a large part, and fright, fear, anxiety and the sight of’ blood, bodily injury, persons suffering, receiving injections etc are common predisposing factors. Many who faint easily tend to show other indications of psychoneurosis. It is also common during the latter stages of pregnancy when the distended uterus presses on the vessels taking the blood back to the heart.
Usually simple measures are quite adequate. Lying down is often sufficient in itself, for the blood mechanically returns to the brain.
Simple first-aid measures:
- Lay the patient down with the head lowered, and the lower limbs raised.
- Encourage the patient to take deep breaths if conscious.
- Loosen clothing about the neck and waist (e.g. tie, belt, tight underclothes etcetera).
- Give plenty of fresh air. Open the windows and doors. Get rid of close-crowding bystanders (common in outdoor situations where the mob invariably gathers to see what is occurring).
- If the patient is sitting and cannot lie down, help to press the head between the knees. This mechanically helps the blood flow to the cerebral centers and can assist in recovery.
- Give reassurance, and speak words of a positive nature. Never instill fear, or tell doubtful anecdotes of disaster, but give a positive, helpful approach at all times. Sometimes syncope is of a different origin, and can herald a more serious situation.
In such cases, the usual premonitory symptoms of simple faint are absent. The attack will come on abruptly and without warning. Usually there is pallor, loss of consciousness may be prolonged and there may he convulsions. Cardiac infarction and various forms of heart block and valve diseases may produce this. Treatment must be preceded by full medical investigation to determine the cause, and this is in the province of the doctor and hospital.