Medical Emergencies
Syncope (Fainting)
This page discusses Syncope (fainting). This is a relatively common emergency, and the dental team should always be prepared to manage it correctly if it occurs.
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The video discusses the causes and treatment of fainting, a common physiological response that may occur due to factors such as pain, exhaustion, hunger, emotional stress, or prolonged standing or sitting in hot conditions. It emphasises the key indicators of fainting, including unresponsiveness, a slow pulse, and pale, cold, and sweaty skin.
In the event of someone fainting, the video advises to first lie them down and raise their legs to enhance blood flow to the brain. It highlights the importance of ensuring the individual has fresh air by moving bystanders away and opening windows if indoors. Typically, the person should regain consciousness within a few minutes; during this time, reassurance is very important.
If the individual does not respond after a couple of minutes, the video instructs viewers to open the airway, check for breathing, and prepare for further treatment as needed. It concludes with a reminder of the key steps to take when assisting someone who has fainted, reinforcing the importance of providing support until they are fully recovered.
If you prefer to view this page as didactic information, rather than as a self assessment, click the arrow below.
Didactic Information:
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Syncope is a sudden loss of consciousness caused by a lack of oxygenated blood reaching the brain.
Vasovagal (situational) syncope is the commonest type, caused by frightening situations such as having an injection.
Syncope due to Orthostatic Hypotension - standing up too quickly – may occur, especially if the patient is on hypotensive medication
It is also associated with some heart conditions, particularly rhythm abnormalities..
Signs and Symptoms
Patient feels light headed.
Pallor
Clamminess, sweating.
Loss of consciousness
The patient may have a slow pulse rate (although it can be rapid with some types of syncope), and low blood pressure.
Precautions
Routinely enquire about fainting while taking the medical history. If it’s happened before, it may happen again.
If a patient is known to faint often, getting them to tense their leg and arm muscles may reduce the degree of hypotension that occurs when, for example, they have an injection.
If a person is known to be on anti-hypertensive medication, give them plenty of time to leave the chair at the end of a visit, and stand nearby to support them if they feel dizzy.
Fainting is more likely to occur if the patient hasn't eaten, hasn't slept, is dehydrated, or emotionally distressed. Appropriate advice should be given to patients attending for dental treatment.
Management
The patient should be laid flat, and the legs raised, to help re-perfuse the brain.
Give Oxygen (15 litres / minute), and loosen tight clothing round the neck.
Monitor carefully for breathing and circulation, consider CPR if absent.
Recovery should be quick with a syncope. If recovery is delayed, consider other diagnoses.
Self Assessment
What is syncope, and what are the common types?
What are the signs and symptoms of syncope?
What precautions can you take to reduce the chance of a patient fainting?
What should you do if your patient faints?