"How to Prevent Fainting"
Syncope, otherwise known as fainting, is the sudden brief loss of consciousness
caused by diminished blood flow to our brain, that occurs at least once
in about one in five people, and in about one in ten may happen over and over,
responsible for millions of emergency room visits and hospitalizations.
Though sometimes fainting can be caused by heart problems,
most often it's triggered just by standing, because blood pools in our legs,
or strong emotions and are called vasovagal reactions.
Under certain circumstances, such as blood donation,
syncope has important medical and societal significance.
More than 150,000 people experience fainting spells or near fainting spells each
year when they're giving blood, and so it would be good to find a way to avoid it.
But if you think that has medical and societal significance,
what about fainting when you're driving?
It goes without saying that losing consciousness while driving
can pose a serious threat to the patient and society.
Of a group of folks getting tested for it, 9% report they had lost consciousness
while driving. When it happens over and over, drugs and surgery are used,
installing a pacemaker, but such therapy is expensive,
efficacy is questionable, and adverse effects are common.
In fact, results of most drug treatment trials
have been disappointing, and the value of implanting pacemakers
has been repeatedly questioned, and now there is evidence
for their lack of effectiveness. So what do we do?
Well, in Italy, evidently the older generation of general practitioners
advised patients prone to fainting to carry a wooden egg
(used in the old days for darning socks)
and to apply muscle tension by gripping the wooden egg forcefully
as soon as a faint was imminent.
These folklore stories inspired an Italian cardiologist
to apply arm muscle tensing to combat vasovagal fainting,
but it wasn't put to the test until now.
About a minute before losing consciousness,
most about to faint experience so-called prodromal symptoms.
They feel dizzy, queasy, or break out into a sweat,
signaling they're just about to black out.
When that happens, there are a number of maneuvers
shown to successfully abort the impending episode.
One is called isometric arm counter-pressure,
where you grip one hand in the other and exert pressure
trying to pull your arms apart, and you keep it up until the symptoms go away.
How successful is it? Patients were shown how to do it, and reported
it was successful 99% of the time.
Safe and effective, proposed to be the new first-line treatment
for those who start to feel faint.
Leg crossing and muscle tensing has also been shown to work,
where you cross your legs, squeezing them together
as you tense your leg, stomach, and butt muscles.
Safe, inexpensive, effective — they propose having patients try this
before having a cardiac pacemaker surgically implanted.
Squatting down is another maneuver if all else fails.
Is there anything we can do to prevent the symptoms in the first place?
Do we have to wait until we're all dizzy, clammy, and sweaty and nauseous?
Well, speaking of cheap, safe, and effective, just drinking water can prevent it.
So if you know needles make you woozy, five minutes before you get stuck,
chug down two cups of water which can dramatically bring pressures up
within minutes in people who are predisposed to fainting,
and have similar effects in normal healthy adults.
The fact that water exerts such profound effects
can be exploited by blood donation programs,
for example, to help prevent people from fainting.
It's also the currently recommended treatment
for so-called blood-injury or injection phobia,
which is actually pretty common, affecting about 1 in 25 people,
75% of which report a history of fainting in response.
The problem is not just that they won't donate blood.
Avoiding anything related to blood, injury, or injections
could pose a particularly serious threat
if people neglect to seek medical care
when necessary, but all one may have to do
is just preload with two cups of water.
The knowledge that such simple self-help maneuvers
are readily available and could be lifesaving
should prove valuable and helpful in everyday life.