Manipal Nurse Sunday Column: When you Faint and Fall…

Episodes of faintness, lightheadedness and giddiness and reduced alertness and fainting are common in many people when they get shocking news or due to some incident which occurs in their presence. It comprises of a generalised weakness of muscles, with inability to stand upright, and temporary loss of consciousness. This is called typical syncope. While faintness refers to the lack of strength with a sensation of impending loss of consciousness.

At the beginning of the attack a person is always in an upright position, either sitting or standing. Usually a person is warned of the impending faint by a sense of feeling bad. He feels giddy, the floors seem to move, and surrounding objects begin to sway. His menses become confused, he yawns or gasps, there are spots before his eyes, his vision may dim for a while and ringing sounds appear in the ears. Nausea and vomiting may follow these symptoms. The person looks pale and the face becomes ashen gray in colour. Very often the face and the body is filled with cold perspiration. The slow onset may enable the person to protect himself as he slumps, and a hurtful gall is very rare.Fainting

If the person is made to lie down early the attack may be averted, without complete loss of consciousness. The depth and duration of unconsciousness vary. Sometimes a person is not completely oblivious of his surrounding or there may be complete lack of awareness and capacity to respond. He may remain in this state for seconds to minutes or even as long as half an hour. Usually he lies motionless with muscles relaxed, but few jerks of the limbs and face may occur in exceptional cases, shortly after he becomes unconscious. The pulse is feeble or cannot be felt, the blood pressure may be low, and breathing almost imperceptible. Once the person is in the horizontal position perhaps after the fall, gravity no longer hinders the flow of blood to the brain. The strength of the pulse then improves, colour begins to return to the face, breathing becomes quicker and deeper, and consciousness is regained. From this moment onwards there is a correct perception of the surrounding. But he or she should not rise soon, as another attack may be precipitated.

Nature has provided man with several mechanisms by which his circulation adjusts to the upright posture. Approximately three fourths of the systemic blood volume is contained in the venous system, and any interference with venous return may lead to a reduction in heart output. Brain blood flow may still be maintained as long as other unimportant vessels in the body remain narrowed, lowering the blood flow in these vessels, which in turn help to maintain proper blood pressure to keep the blood flow to the brain intact. But when this adjustment fails there is serious low blood pressure, which will reduce the blood flow to the brain giving rise to a fainting attack.

The common attack of fainting that may be experienced by normal persons is frequently recurrent and tends to take place during emotional stress, after a bad shocking news, during attack of severe pain, seeing of accident or blood, etc. Other conditions which may precipitate this type of attack are poor physical condition, prolonged illness and bed rest, anemia, fever, heart disease and fasting for a long time. At the start of the attack the person may feel nausea, perspiral stomach distress, fast breathing, weakness, confusion and dilatation of pupils of the eyes. This is followed by a weak pulse and fall of blood pressure and if the person is not made to lie down flat on the ground he may fall. In some elderly persons the bladder reflex and passing of urine, may play as a starting reflex giving rise to fainting.

Fainting in most instances is relatively safe. If a person is seen in the preliminary stages of fainting, he should be placed flat horizontally, all tight clothing should be loosened and head turned to the side and fully extended, so that the tongue does not fall back and block the air way. Peripheral stimulation like sprinkling of cold water on the face or application of cold towels may help. If the temperature is below normal the body should be covered with a warm blanket. The person who has fainted should not be given any eatables or drinks for some time. He should not be allowed to get up from a lying down position for some time till he gets full consciousness. He should not be permitted to rise and walk till his sense of physical weakness has passed. In elderly people the fall due to fainting may cause collateral damage like fracture or head injuries or eye injuries, so they should avoid sudden getting up from bed or from the lying position.

About Nurse 69 Articles

When I think about all the patients and their loved ones that I have worked with over the years, I know most of them don’t remember me nor I them. But I do know that I gave a little piece of myself to each of them and they to me and those threads make up the beautiful tapestry in my mind that is my career in nursing.