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    A fainting spell can be a frightening experience, especially if it’s never happened before. What might cause such an episode? Is it a sign of worse things to come? Dr. Garrett Luettgen, Emergency Medicine Physician at Pullman Regional Hospital's Emergency Department, sheds light on why people faint, what happens when a person faints, and what can be done to mitigate its occurrences.


    What causes fainting?


    Fainting happens when a person has a temporary loss of consciousness caused by insufficient oxygen delivery to the brain. This most commonly occurs from a vasovagal response, where the part of the nervous system that regulates blood pressure and heart rate malfunctions in response to some kind of trigger. Such a trigger might be pain, an environmental factor, or emotional distress. For example, a number of people get woozy at the sight of a needle or blood.


    There are also underlying medical conditions that contribute to fainting, such as diabetes, heart disease, and certain neurological issues. Sometimes, medications can also lead to fainting episodes. In more recent times, some people who are living with long COVID have developed postural orthostatic tachycardia syndrome (POTS), which may contribute as well.


    Symptoms and Duration


    Oftentimes, fainting episodes are preceded by numerous amount of symptoms, including dizziness, blurred vision, weakness, pale skin, rapid breathing, or nausea. “You can also include things like headache, feeling unsteady, or seeing spots in your vision. Other concerning symptoms can also include things like chest pain or shortness of breath,” states Dr. Luettgen.


    Typically, a fainting spell lasts anywhere from a few seconds to under a minute. Anything lasting any longer than 60 seconds should be evaluated sooner rather than later.


    Does a Fainting Episode Warrant a Trip to the ER?


    In cases where individuals faint due to something like an emotional trigger (e.g. needle, blood), a trip to the emergency room probably isn’t necessary. These people generally come to understand what is causing them to pass out. However, Dr. Luettgen notes there are cases when an ER visit is warranted.


    “When we think about reasons to come see me in the emergency department or to seek some sort of medical attention, that's when we would think about something like prolonged loss of consciousness. Older patients, especially, tend to be at higher risk for having some of the more serious and concerning causes of their episode of fainting.”


    Additional considerations include any exercise-related episode, such as a youth athlete fainting during an activity; fainting accompanied by heart palpitations; and a family history of passing out.


    What Should You Do If Someone Passes Out?


    If you’re with or near someone who starts to feel lightheaded, Dr. Luettgen advises getting them as close to the ground as possible in order to limit an injury from a fall. Then, try to get them laid flat and prop their feet up above the level of their heart.


    “This may help blood from the legs passively return to the heart and might help their blood pressure get a bit better. Once they're feeling improved, get them to sit up and place their head between their knees and keep them in that seated position. If they're awake and talking for about 10 to 15 minutes, and if they're able to drink fluids and they're not vomiting, go ahead and offer them something to drink, preferably something with electrolytes.”


    Of course, if a person is experiencing a prolonged loss of consciousness or not breathing, it is absolutely time to call 911 and get EMS involved.


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