People who have fainted should be placed flat on their backs or with their head lowered between their knees to help restore blood flow to the brain. All tight or constrictive clothing should be loosened. The head should be turned to the side to prevent the tongue from falling into the throat, and to prevent vomit from blocking the airways. No food or liquid should be provided until the person regains full consciousness. In some cases, sprinkling the face of the person with water or applying cold, moist towels is helpful. The person should be kept lying down or sitting until the weakness has passed. Someone should remain watching the person carefully for a few minutes after he or she rises.
Get emergency help if the patient isn’t breathing or has no pulse, or if the person hit their head when falling. Depending on the specific circumstances, emergency medical care may include clearing the airway and/or performing cardiopulmonary resuscitation (CPR). Emergency medical technicians may also establish an intravenous (IV) line, provide sugar or medications as necessary, or use electrical shock paddles applied to the chest (defibrillator) to reestablish normal heart rhythm.
In some cases, especially when the patient is at risk for heart attack or stroke, hospitalization may be required. Although most cases of fainting are relatively harmless, massive internal bleeding, heart attack, or stroke are medical emergencies and may require hospitalization.
Avoid any factors or triggers that you know will cause you to faint. Alcohol, fatigue, hunger, caffeine, and emotional extremes may trigger or aggravate fainting. Avoiding these triggers will reduce your risk of fainting. People who faint when standing up too quickly can reduce their risk of fainting by changing position slowly. Men who faint when urinating can reduce their risk of injury by sitting down to urinate.
To reduce your risk of injury, sit down when you experience any symptoms that precede fainting. Sitting down may not eliminate the risk that you will faint, but it will reduce the distance you fall should you lose consciousness.
Talk to your physician about increasing your salt intake if your fainting is associated with low blood pressure. Patients with high blood pressure should not take this approach. For some people with recurrent fainting, a high-salt diet combined with fluid is recommended to avoid dehydration and maintain blood pressure. Your physician will help you determine whether this approach is appropriate for you.
Your doctor is the best source of information on the drug treatment choices available to you.
If your fainting is caused by a severely abnormal heart rhythm, your physician may recommend implanting a pacemaker.
Surgery is generally not required for fainting, although it may be required to treat underlying heart disease that causes fainting. For example, defective heart valves that reduce the efficiency of the circulatory system may require surgical repair or replacement.
If your fainting is caused by a blockage in the carotid artery of the neck, you may have to undergo surgery. For this procedure, a surgeon will make an incision in your carotid artery, remove the blockage, and sew up the incision. This surgery is generally very successful. You will need a follow-up appointment about a month after the surgery to check the wound, and to check your blood pressure. After that appointment, you will need to return once a year to make sure the blockage doesn’t recur.
People who experience recurrent fainting should consider the risks before deciding to continue to drive or to work in occupations where serious injury may result from fainting.
The prognosis for a person who faints depends on the underlying cause of the fainting. People who faint as a result of a heart condition have a worse prognosis than those who faint as a result of a non-cardiac condition. For example, the one-year mortality rate for patients with fainting caused by cardiac disease is higher than for people with non-cardiac or unexplained fainting. This difference, of course, can be attributed to the serious long-term consequences of heart disease, including heart attack and stroke.
Repeated fainting is not associated with a worse prognosis than having a single fainting episode. About a third of people who have an episode of fainting will experience a recurrence, regardless of the cause of the fainting. However, people who have repeated episodes of fainting are no more likely than those who have a single incident to have a poor prognosis. It is the underlying cause of the fainting, not the number of times a person faints, that determines the long-term prognosis.
Recurring episodes of fainting reduce quality of life. Even when fainting is not associated with serious underlying disease, it can have a dramatic impact on a person’s quality of life. Most people who have recurring episodes of fainting will alter their daily lives to cope. Some drive less frequently, or change jobs to reduce the risk of injury should they faint at work. Nearly 75% of people with recurring fainting experience anxiety or depression; especially when the condition is not diagnosed or treated effectively.
Follow-up for fainting varies according to the symptoms, frequency of fainting episodes, and underlying causes. Whether or not long-term treatment is necessary depends on the cause of the fainting. For example, in cases where fainting is associated with heart disease or metabolic disorders such as diabetes, periodic follow-up is usually necessary in order for the doctor to monitor medications and treatment. Some types of fainting do not require any long-term treatment.
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