Vasovagal syncope (simple faint) ED

What is vasovagal syncope?

• This is the term used to describe one of the most common causes of fainting. Pooling of blood in your legs as a result of gravity causes your blood pressure to drop. This means less blood is getting to your brain which may lead to dizziness, falls and blackouts.

• Vasovagal syncope is not life threatening and usually gets better with simple measures but it is possible that you may injure yourself during a fall or blackout.

What are the symptoms?

• You may feel dizzy, look pale, feel sweaty or sick or develop blurred vision.

• You may notice sounds becoming distant. You might fall or blackout.

How is it diagnosed?

• It can usually be diagnosed based on your symptoms alone.

• Sometimes we refer you to our Rapid Access Clinic for the Older Person (RACOP) for a more in-depth investigation of the underlying cause for your symptoms if one is not immediately obvious. It is here they will decide if you need further tests such as tilt table testing, if appropriate.

Your risk of fainting can be increased by

• Dehydration.
• Medication. Your doctor will review your medications and stop any that may be contributing to your symptoms.
• Standing still for long periods of time.
• Emotional distress or stressful situations.
• Seeing blood or having injections.
• Eating a large meal.
• Warm environments.
• Straining, such as when opening your bowels or passing urine.

• Try to keep hydrated by drinking noncaffeinated fluids such as water or squash. Try to drink at least one litre in the first few hours of the day. Limit your caffeine intake to no more than three cups of coffee, tea or cola a day.

• Avoid drinking above the recommended alcohol limit. Alcohol can dehydrate you making your symptoms worse.

• Eat regular meals.

• Avoid standing in the same position for long periods of time, for example in queues, on public transport or at religious ceremonies. Sit on a chair if possible.

• If you do have to stand, then clench and unclench your calf muscles or rock forwards on the balls of your feet to encourage blood flow and raise your blood pressure.

• Avoid sudden changes in your position. Take your time getting up from your bed or chair and pause between changes in your position, especially in the morning after you have been lying down overnight.

• Your doctor may give you compression stockings that you should wear as and when directed.

• Your symptoms may be worse when you are unwell so it is really important that you drink plenty of fluids when you have diarrhoea, vomiting or flu like illness.

What should I do if I feel dizzy or faint?

If you act quickly you can prevent yourself from fainting. You should

• Lie down IMMEDIATELY. Sit down if you are unable to lie down.

• If possible lie down with your feet and legs raised higher than the rest of your body.

• Clench and unclench your fists and calf muscles or rock forwards on the balls of your feet if you are seated and unable to lie down. Tensing your muscles in this way will help blood flow and help increase your blood pressure.

Stand up slowly and carefully. If you still feel faint repeat the above steps.

When to seek further help.

Seek immediate medical attention if you have severe chest pain, breathlessness, or palpitations before you fainted, if you have not quickly recovered or if have seriously injured yourself.

For general medical advice please use the NHS website, the NHS 111 service, walk in centres, or your GP.

The NHS website provides online health information and guidance www.nhs.uk.

NHS 111 phone line offers medical help and advice from trained advisers supported by nurses and paramedics. Available 24 hours a day. Calls are free from landlines and mobile phones.

There are walk in and urgent treatment services at Brighton Station, in Crawley and at Lewes Victoria Hospital. www.bsuh.nhs.uk/services/ae/.

Patient Advice and Liaison Service (PALS) can be contacted with your comments and concerns, and to provide general support. Email PALS@bsuh.nhs.uk.

RSCH, telephone 01273 664683.

PRH, telephone 01444 448678.

PALS, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE

This information is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

This article is intended for patients receiving care in Brighton & Hove or Haywards Heath.