#autonomic dysfunction

{1} how to prevent a fainting episode

first things first, let’s talk prevention. sometimes, people will experience symptoms before they actually faint. if you’re observant enough, you might be able to recognize these signs and take action before the person faints. some signs that someone might be about to faint include:

pale or ashy-looking skin

cold, clammy skin

flushed skin

sweating

slurred speech

dropping things

shakiness or tremors

complaints of a headache

appearing detached or out of it

looking or claiming they feel sick

unsteadiness (swaying, stumbling)

sensitivity to light (squinting, blocking their eyes)

if you notice someone exhibiting one or more of these signs, it's worth going up and asking if they're okay. sometimes people don't understand what's happening, or don't put the pieces together, and even asking if they are okay might be enough for them to work out that they are about to faint.

if they do say yes (or don't know but you suspect they are about to faint), it's time to take action. fainting can happen in the blink of an eye, so make sure you stand close by with your arms at the ready. if you can, help guide them down to the floor, making sure you tell them what you are doing. something like "let's get you on the floor" will work. that should be your top priority. if they cannot lay down, guide them to sit on the floor or the nearest available seat. get them as close to the ground as possible so if they do faint, they are at a lower risk of hurting themselves. guide them to place their head between their knees.

the steps for what to do next are virtually the same as in the next part, so to avoid repeating myself, I will just move on.

{2} if the person has fainted, check to make sure they aren't in immediate danger.

the first thing you should do if someone is unconscious is CHECK FOR A PULSE. if they do not have one, immediately start CPR, call for an ambulance. this should be your number one priority. everything else can come later.

once you've determined they are still alive, you can start checking for injuries. don't try to move them right away, especially if you think they may have hit their head. check for bleeding, bruising, broken bones, etc. if you see any major injuries, call for an ambulance.

also, take the time to check the environment around you. make sure they are not in a dangerous location (ex: near the top of a flight of stairs, on or very near the road, in areas with high foot traffic, etc). if they are, take the time to move them.

THIS IS IMPORTANT: if the person has a service dog, do not impede its duties!! do not try to move the dog. check for medical ID (either on the person or on the dog). if you find something that indicates something serious may be going on, or if the dog tries to alert you or get your attention, call for an ambulance.

{3} get the person conscious again.

if they are not in immediate peril, congratulations! now you get to start on the process of getting them conscious again. of course, it's very likely they will regain consciousness on their own after a few seconds, but even if they do, these are important steps to take to help them recover quicker.

here's some things you should do:

shift the person onto their back and elevate their feet above their heart. this helps get blood flowing back to the brain.

remove any excess layers and loosen any tight clothing.

get some water or a cool compress and apply it to areas like the face and the back of the neck.

make sure they have enough room to breathe. if there's a crowd, you should try to get them to back away.

if the person doesn't appear to be in any immediate danger, there is no need to call an ambulance at this point.

if the person has been unconscious for longer than a minute, call for an ambulance. this is a sign that something more serious may be going on. also, if the person has difficulty regaining consciousness, or lapses back into unconsciousness, that is also a sign you need to call for an ambulance.

if the person has a service dog, you can and should still do all of these things (without impeding the dog's tasks). do not distract the dog or assume that the dog will do everything.

{4} help the person recover after regaining consciousness.

once they have woken up, you can begin the post-fainting recovery process.

ask the person the following questions: 1) how are you feeling? 2) does anything hurt? 3) have you ever fainted before? (if they have not and there is no obvious cause for the fainting, call 911) 4) do you want me to call someone for you?

continue to have the person elevate their feet and apply a cold compress for at least ten minutes, or until they are feeling better.

once they are ready to stand, remain close by in case they lose consciousness again.

once they are upright again, offer them some water.

if they have fainted because of low blood sugar or they have a condition like POTS, try to find them something small to eat. again, only do this when they are upright again.

treat any (minor) injuries they might have sustained.

make sure they have a way to get home (or wherever they are going) safely. encourage them to rest, drink fluids, and eat.

{5} what not to do if someone faints.

do not panic. fainting is very common and usually no cause for concern. a healthy amount of worry is good, but don't get too worked up about it. that could impair your ability to help.

do not call an ambulance if the person tells you not to call an ambulance, especially if this person has a history of fainting. not every fainting episode warrants a trip to the ER, and having paramedics hovering over you can be way more stress than it's worth.

do not elevate the head. the reason you collapse is because your body is trying to get bloodflow back to the brain. elevating the head usually will either not help, or it may be actively harmful. this include placing items like pillows or folded clothing under the person's head, or placing their head in your lap.

do not get them up too quickly. ease them into standing after they have been laying down for several minutes (or when they feel ready to stand). getting them up too quickly raises the chances of having another fainting spell.

do not shake the person aggressively or try to "shock" them awake by slapping them.

do not give them anything to eat or drink while they are laying down or while they are still unconscious.

don't pour water on them, especially not on their face. get a damp cloth, a water bottle, or ice pack instead.

don't leave them alone. if you must leave, make sure someone stays with them until they are up on their feet again.

don't force treatments onto them. if they say they don't need water, food, or your further assistance, listen to them.

{6} times when you should and shouldn't call an ambulance.

you should call an ambulance if:

the person has been unconscious for more than one minute.

the person is not breathing and/or does not have a pulse.

the person has a serious injury, or there is a risk they may have hit their head.

the person is pregnant.

the person is having difficulty waking, or appears extremely confused upon waking up.

the person faints multiple times.

it is the person's first time fainting.

you suspect there may be a more dangerous reason that the person has fainted (ex: stroke, heart attack, etc.)

the person has a seizure or begins exhibiting symptoms not associated with normal fainting (ex: shortness of breath, chest pains, arrythmia, difficulty moving).

you probably don't need to call an ambulance if none of the above are true, but especially so if:

the person has a history of fainting.

the person fainted for a known and non-serious reason (ex: low blood sugar, dehydration, heat, stress, etc).

the person is alert, talking, and improving afterward.

the person is young, healthy, and has no other symptoms.

there are no signs of major injury.

the person regains consciousness quickly.