Knowing how to respond when someone faints or loses consciousness can save a life, especially when it happens without warning.
The primary cause of this phenomenon is syncope, commonly referred to as fainting. According to StatPearls, syncope accounts for 1% to 3.5% of all emergency department cases, and contributes to 6% of hospital admissions in the United States. But there are other reasons for loss of consciousness as well.
Understanding the appropriate actions to take in such an emergency can make a difference in the long-term outcome.
What causes fainting or loss of consciousness?
Fainting, also known as passing out, commonly occurs due to a drop in blood pressure, slowing blood flow and oxygen supply to the brain, says the Cleveland Clinic. In most cases, fainting spells are not a cause for concern. However, if you experience recurrent loss of consciousness or notice any other concerning symptoms, ask your doctor for proper evaluation and guidance.
“Simple fainting is the primary reason we see people lose consciousness,” said Dr. Jim Keany, co-director of the emergency department at Providence Mission Hospital in Orange County, Calif. “In these situations, the body is having a vasovagal response to something, which means the body is overreacting to a certain trigger. The parasympathetic nervous system jumps in to conserve energy. In fact, the most common location where emergency responders find people who have passed out is in the bathroom. This is because urination or a bowel movement can trigger that vasovagal response, thus contributing to a loss of consciousness.”
“In most situations, the person will wake up within a moment or two and be relatively lucid," he added. "They should be aware of their surroundings. If this is the case, there isn’t typically cause for alarm.”
Fainting and loss of consciousness signs and symptoms
The Mayo Clinic indicates that before experiencing vasovagal syncope, individuals may experience the following symptoms:
- Pale skin
- Lightheadedness
- Tunnel vision
- Feeling warm
- A cold, clammy sweat
- Nausea
- Blurred vision
Further, during a vasovagal syncope episode, bystanders may observe:
What to do if someone faints or loses consciousness
After fainting or losing consciousness, some people may return to normal in a few minutes, while others may wake up and seem disoriented, confused, incoherent or unaware of their surroundings. In any cases of fainting or loss of consciousness, call 911 or go to an emergency room so they can be evaluated by a healthcare provider. People may faint for different reasons, so treatment or follow-up may depend based on what caused the fainting or loss of consciousness in the first place.
Keany shared that a person can often experience a sudden loss of consciousness without warning due to low blood sugar, also known as hypoglycemia. “When people don’t eat enough or forget to eat, and their activity level is super high, they can burn through all that sugar in their body and pass out,” he said. In these situations, have them eat a small, well-balanced meal or snack and have them rest until they feel well again.
He also mentioned that people with diabetes often experience fainting episodes if they have taken their insulin but haven't eaten. In these cases, “they should be given some sugar, so that their body can regain its balance. And in situations that are medicine-induced or they are having trouble coming around, they should be taken to the emergency room.”
Know your ABCs
“When someone loses consciousness, the best action is to follow the ABCs or CABs: Check to see if their airway is open. Is there something in their mouth blocking their airflow? It could be that the tongue is blocking their airway. Check to see if they are breathing. If they are not breathing, you may need to breathe for them. And, most importantly, check for circulation. If there is no pulse, start CPR and call 911,” Keany said.
“Even in the most common situations, if someone passes out, the first move is ABC. Anytime you come upon someone in distress, start with ABC. I’m always thinking ABC for every patient when I walk into the emergency room,” he shared. “That said, there is also a D that comes into play, representing disability. If there is any chance of neck trauma, you want to focus on protecting the cervical spine. Call 911 for guidance on what to do.”
What to do if someone doesn’t regain consciousness quickly
A fainting episode should only last a few seconds. But don’t assume right away that all is well. “Following the ABCs, airway, breathing and circulation, is a good recommendation in any medical situation,” Keany advised. “If the person isn’t coming to in a few seconds and their pulse is weak, or there is no pulse, you need to seek medical attention immediately.”
When to get help
An article published recently by the American College of Emergency Physicians suggests that if you experience a faint feeling, promptly sit or lie down. If you choose to sit, bend forward with your head between your knees to aid blood flow to your brain. Wait until you feel better before attempting to stand up. Taking these actions can help prevent injuries and facilitate a quicker recovery.
If someone you are with faints, place them on their back and, if feasible, elevate their legs above the heart. Ensure they are breathing and loosen any tight clothing or belts. If the person does not regain consciousness within a minute, call 911. Responding with these actions can be crucial in providing timely aid.
What to do while you wait for help
What to do while you are waiting for help depends on the person’s condition. For example, if they are not breathing or do not have a pulse, you should begin CPR. If you have been trained in CPR, follow the guidance from your training to care for the person until help arrives.
The American Red Cross and Mayo Clinic list the following steps for CPR:
- Check the scene: Ensure the area is safe for you and the victim. Approach cautiously.
- Check for responsiveness: Gently tap the victim and shout loudly, "Are you okay?" Look for any signs of movement or responsiveness.
- Call for help: If the victim is unresponsive and not breathing (or only gasping), call emergency services right away or ask someone you are with to dial 911.
- Check breathing: Look, listen and feel for signs of normal breathing for no more than 10 seconds. If the victim is not breathing or only gasping, start CPR.
- Begin chest compressions: Place the heel of one hand on the center of the victim's chest, just below the nipple line. Use the other hand to interlock fingers. Position yourself with your shoulders directly above your hands and elbows straight. Push hard and fast, at least 2 inches deep, at a rate of 100 to 120 compressions per minute.
- Open the airway: After 30 compressions, tilt the victim's head back just a bit and lift their chin to open their airway.
- Give rescue breaths: After the 30 compressions and opening the airway, give two rescue breaths. Pinch their nose shut and cover the mouth with yours, creating an airtight seal. Give a breath that makes the chest rise visibly. Repeat for a second breath.
- Continue CPR: Perform cycles of 30 chest compressions followed by two rescue breaths. Continue until help arrives, the victim starts breathing or you are too exhausted to continue.
Remember, early CPR can greatly increase the chances of survival for someone experiencing cardiac arrest. If you are not trained, seek professional training so you are prepared to perform CPR correctly in an emergency.
Things not to do if someone faints or loses consciousness
If someone you are with loses consciousness and does not come to right away, be sure to follow the guidelines shared above in this article. That said, there are some things you should not do in these situations:
- Do not panic: Stay calm and composed, to respond effectively.
- Do not leave the person unattended: Stay with the individual and offer support throughout.
- Do not slap or shake the person: Avoid any aggressive physical actions that may cause harm.
- Do not force the person to stand: Allow them to lie down or sit comfortably if conscious.
- Do not give food or drink: Refrain from offering anything to eat or drink until fully conscious.
- Do not delay calling for help: Seek professional medical assistance immediately if needed, especially if there is no sign of a pulse or the victim is showing signs of a weakened pulse.
Following these guidelines can help ensure the person's safety while waiting for professional help.
