First aid for fainting spells

Signs and symptoms of presyncope or the feeling one gets before the onset of a fainting spell include:

• Lightheadedness
• Generalised weakness
• Dizziness
• Confusion
• Tunnel vision or loss of peripheral vision temporarily
• Blurry vision
• Slurred speech
• Trouble hearing
• Sweating
• Nausea or vomiting
• Headache
• Heart palpitations

Signs and symptoms usually seen in a fainting spell are:

• Dizziness and lightheadedness
• Colour drained from the face or a pale face
• Excessive perspiration or sweating
• Anxiety, restlessness and nausea
• Collapse
• Unconsciousness, typically for a few seconds followed by full recovery after a few minutes

Alarming signs and symptoms associated with fainting that need emergency medical care at a hospital:

• Unconscious for longer than a minute
• Blue discolouration of lips, tongue or face
• Irregular or slow heartbeat
• Chest pain
• Difficulty breathing
• Breathing stops
• Seizure, or a fit of abnormal body movement with frothing at the mouth, lasting more than 1 minute
• Unarousable (the patient can’t be brought out of the fainted state)
• Altered mental status and confusion

Following are the steps to follow while giving first aid to a patient experiencing a fainting spell – presyncope or syncope.

In the case of presyncope, or when the patient has not fainted but feels dizzy or lightheaded, keeping the following in mind:

• Reassure the patient
• Sit or lie the patient down
• Ask the patient to place their head between their knees, if sitting, to restore blood flow and circulation to the brain
• If a person feels faint while standing, moving their toes and stiffening and relaxing calf muscles can help restore blood flow and prevent fainting.

First aid steps to follow when the patient has fainted:

• Lay the patient on their back
• Loosen any tight restrictive articles of clothing like belts, neckties, etc. 
• Raise the patient's legs above the level of their heart, which is at least 12 inches or 30 centimetres off the ground, with their head on the ground. This will help restore blood flow to the brain.
• If the patient does not regain consciousness within a few seconds (under a minute), check their breathing.

If the patient is unconscious, not breathing and does not regain a pulse or breathing in the next 10 seconds, begin CPR and call for an ambulance. The steps to provide CPR (cardiopulmonary resuscitation) are:

• If untrained or unsure, only give chest compressions as follows:
• Lay the person flat on their back and kneel next to them.
• Position your hands with the palm of one hand over the back of the other and fingers interlocked.
• Place your hands on the patient's chest with the palm of the lower hand over the centre of the chest.
• Keep your elbows straight and position your shoulders directly above your hands.
• Push straight down with the weight of your entire body to compress the patient's chest to a depth of 2 inches.
• Push hard at a rate of 100 to 120 compressions a minute.
• Continue chest compressions till there is any sign of movement in the patient or the emergency medicine team reaches you.

If the patient is unconscious but breathing and has no other life-threatening conditions, they should be placed in the recovery position and help should be called. Steps to place a patient in a recovery position are:

• Lay the patient flat on the ground and kneel next to them.
• Extend the patient’s arm closest to you at a perpendicular or 90-degree angle to their body.
• Fold the other arm (the one away from you) such that the back of that hand is placed against the opposite cheek (the one closest to you).
• Fold the leg farthest from you at the knee at a right angle.
• Gently roll the patient to their side by pulling on the folded knee (farthest from you). 
• The bent arm should support the head and the extended arm will stop the patient from rolling.
• Gently tilt the patient’s head back a little and lift their chin. This will keep their airway open.
• Keep the patient in this position and watch them till help arrives.