(ANN/dpa/THE STAR) – You may have heard that people who feel faint should sit with their heads between their knees, but is that true?
And how can you tell whether you or someone else who has fainted should go to the emergency department, or perhaps even see a cardiologist?
Fainting or blacking out, also known as syncope, is a temporary loss of consciousness due to insufficient blood flow to the brain.
There are different types of syncope.
Vasovagal syncope is the medical term for the most benign kind of fainting, i.e. simple fainting without a serious underlying cause, explains Mayo Clinic Healthcare cardiologist Dr Elijah Behr.
Usually with this type of fainting, the person falls to the floor, blood pressure returns to the brain and the person starts to recover.
However, if someone faints in a vulnerable location or vulnerable position, it can be dangerous to that person and others, Dr Behr notes.
Worrying cause
The syncope that most concerns healthcare professionals is cardiac syncope, i.e. blacking out due to an underlying heart disease such as a heart rhythm abnormality or arrhythmia, he explains.
“This is usually a more abrupt loss and return of consciousness than in simple fainting. If you’re older, you’re more likely to have underlying heart disease that you may or may not be aware of. That’s one of the reasons to be more concerned about loss of consciousness in older individuals,” says the doctor based in London.
He adds that others for whom a blackout can be a warning sign of a serious heart problem include:
> People with a family history of inherited heart problems, unexplained deaths or premature sudden deaths
> People whose fainting is related to exercise, and
> People whose fainting is associated with heart palpitations or the heart feeling like it’s racing away.
Before a simple faint, you might experience one or more signs that you should sit or lie down.
“There will be a sensation of lightheadedness. There may be a sensation of nausea, or buzzing or ringing in the ears,” Dr Behr says.
“Some people describe tunnel vision – their vision closing in on them before they actually pass out – and some may actually lose vision, but still be aware, not lose consciousness completely, and then recover. Other typical signs include feeling sweaty and clammy. Some people get about a half-hour of warning signs before fainting; some people may get 30 seconds,” he adds.
How to help
Here’s what to do if someone faints.
First, check that the person is breathing and has a pulse. If not, call for emergency help, and if you know how to provide cardiopulmonary resuscitation (CPR), initiate it.
If the person is still breathing and has a pulse, ensure that they are lying flat and their airway is open using the recovery position, and call for help.
If you yourself feel like a faint may be coming on, position your head lower than your heart, e.g. between the knees.
Rest and drink water after you come out of the faint.
Add electrolytes to the water if you have them.
Sometimes, getting hydrated and adding salt to the diet may not be enough. Occasionally, people need to take medications to improve blood pressure control and increase blood pressure to prevent fainting episodes, Dr Behr says.
Seeking medical help
“If somebody has had simple fainting with the clear precipitants that I described, it is best to have a chat with your GP (general practitioner) to talk about it. Particularly if it’s a first onset of symptoms, it’s best not to ignore it,” Dr Behr says.
If someone has had simple faints before, the circumstances that bring them on are typical for them, and they have been evaluated by their primary care physician or a cardiologist before, they may not need to go to the emergency department every time, he adds.
The more concerning situations are:
> Older people having faints where other conditions may also be having an effect
> People who are having recurrent faints despite keeping well hydrated
> If there has been an injury due to a faint, and
> If the blackout comes on abruptly and with other signs that there may be an underlying cardiac (heart) condition.
“We need to make sure that they are treated and that something else isn’t being missed,” Dr Behr says.
“Also, faints can sometimes look like seizures. They can cause fitting activity, and differentiating a seizure and epilepsy from fainting requires involvement of a cardiologist and neurologist,” Dr Behr says.
