Fainting (collapse, loss of consciousness) – causes, treatment and prevention

Fainting, also known as collapse or syncope in the medical community, is a temporary loss of consciousness. This form of disturbance of consciousness usually starts suddenly and usually ends just as suddenly.

Typically, in a collapse, postural control is lost, making a sufferer unable to maintain an upright position. In most cases, blood flow to the brain is restricted during fainting.

Many people experience at least one fainting spell in their lifetime. Children and young people can also be affected by a collapse. The reason for the sudden loss of consciousness is usually an undersupply of the brain with oxygen-rich blood.

The causes of fainting spells are often harmless. However, in some cases, serious underlying diseases can also hide behind a collapse. The state of unconsciousness associated with fainting usually lasts from a few seconds to a minute. If the unconscious person cannot be spoken to for several minutes, an ambulance must be called immediately.

causes

Depending on the form of fainting or unconsciousness, the causes also differ. For example, fainting can be caused by the circulatory system (this is also referred to as a so-called circulatory collapse), it can come from the heart (and is therefore a cardiogenic collapse) or it can be caused by cerebral circulatory disorders. In the latter case, one also speaks of a cerebro-vascular collapse in medicine.A collapse can also be triggered by low blood sugar, especially in diabetics. Head or neck injuries (e.g. due to dull force), heat stroke , allergic shock, epilepsy or lack of fluid intake can also trigger fainting or collapse.

Causes of fainting due to circulatory system are, among other things, that the blood in the human body collects mainly in the deep-lying parts of the body when changing position. Depending on the physical constitution, part of the blood can sink into the veins and thus be withdrawn from the bloodstream. This can be the case, for example, if you stand motionless for a long time or remain in an unfavorable position.

A circulatory fainting can also be favored by antihypertensive medication or by an existing pregnancy. A cardiogenic collapse can, for example, be based on cardiac arrhythmias .

In addition, psychogenic factors such as strong emotional sensations, stress or fear can cause unconsciousness. The sight of injured people or a harmless blood draw (syringe!) can trigger a fainting spell.

When to the doctor?

When fainting (syncope) occurs for the first time, a doctor should always be consulted so that the causes can be clarified. Neurally mediated syncope can be triggered by pain, fear, severe stress or extreme temperatures, for example. Brief fainting that occurs again and again can indicate carotid sinus syndrome. Here the receptors of the carotid artery are overly sensitive to pressure. For those affected, a light touch, for example during personal hygiene, is often enough to trigger a brief faint. Such neurally mediated syncope is usually harmless, but the doctor should still be consulted.

This is especially true if those affected have lost consciousness while standing and may have injured themselves as a result of the fall. If a collapse is accompanied by pale skin , cold sweats and blue lips, call an ambulance immediately as these may be signs of severe shock or lack of oxygen. Cardinal syncope, where the heart is the trigger, is particularly dangerous. If pain and a feeling of pressure in the chest area occur in the context of unconsciousness, an immediate visit to the doctor is essential.

symptoms

Fainting usually occurs relatively suddenly. But often certain symptoms point to the impending collapse. Affected people have an increasing feeling of tiredness , their skin becomes sallow and pale, and they start to sweat. There is also nausea , dizziness and a general feeling of weakness and malaise. Usually the well-known “fading out” is the last impression of an affected person before fainting.

diagnosis and course

In order for a medical professional to be able to diagnose the background of a fainting, it is first important to ask about the medical history of a patient. The circumstances surrounding fainting are also important; these may include standing for long periods of time, for example. Previous illnesses or precursor symptoms of a collapse, such as dizziness, nausea or sweating , are usually asked for a more detailed diagnosis. The duration of a fainting is also important.

As part of an examination, a pulse and blood pressure measurement is then usually carried out in different body positions of the patient. If necessary, further diagnostic measures are, for example, a blood test, a long-term ECG , a heart ultrasound (echocardiography) or a computed tomography (CT). The course of a fainting depends above all on the underlying factors. The consequences of the fall caused by unconsciousness are often greater than the actual fainting.

It is not uncommon for people who have passed out to suffer lacerations or even severe craniocerebral injuries as a result of the impact. Depending on the cause and situation, the probability of suffering another collapse or fainting varies greatly.

complications

Unconsciousness is the third state of consciousness alongside sleep and wakefulness, but it is the only state that is intrinsically dangerous. A brief faint lasting a few minutes is usually not associated with such serious complications. However, people can fall unfavorably and thereby incur injuries and wounds.

Complications of unconsciousness can arise from the fact that the muscles relax and the body sags uncontrollably. Depending on the position in which the unconscious person is lying, the tongue can fall backwards because it is also a muscle. In the worst case, people can suffocate – the stable lateral position helps to prevent this. In addition, if you are unconscious, you may stop breathing. If the brain is not sufficiently supplied with oxygen during this time, serious brain damage can occur.

Depending on the body position and the environment, a fall can result in bruises, sprains, abrasions or cuts. Bone fractures can also occur in severe falls.

If you faint while driving a motor vehicle, it can also lead to serious traffic accidents.

treatment and therapy

If a person suffers from acute fainting and unconsciousness, the first thing to do is to check their breathing and pulse. If no vital signs are recognizable, first aid measures must be taken immediately.

If breathing and pulse are present and everything points to fainting due to the circulatory system, the first therapeutic measure is to keep the upper body low and the legs in a slightly elevated position.

In addition, a sufficient supply of fresh air should be ensured. This measure usually means that congested blood can reach the brain, which usually means that the person concerned quickly regains consciousness.If this measure is successful, no further acute therapy steps are usually necessary. However, depending on the background of a fainting, therapy of the underlying factors may be necessary.

If, for example, it is determined during diagnostics that fainting was caused by a circulatory system and if the person concerned is taking antihypertensive medication, it can make sense to find alternatives to the appropriate medication in dialogue with the doctor treating you.

And even if fainting is caused by heart disorders, rapid therapeutic steps can be important. Existing cardiac arrhythmias can be counteracted with a pacemaker, for example, depending on the severity. If the causes of a collapse are eliminated or if they are controlled therapeutically, this usually also leads to a reduction or disappearance of the fainting states that occur.

outlook and prognosis

Unconsciousness should always be treated by a doctor. In most cases, unconsciousness itself does not result in any other discomfort or dangerous situation, but the cause of the unconsciousness should be determined and the underlying medical condition diagnosed. If no treatment is given, unconsciousness may recur. The person concerned may also be injured by a fall. It is not uncommon for those affected to suffer from a panic attack or to break out in a sweat.

An examination is necessary, especially in the case of a long fainting spell. In most cases, unconsciousness occurs due to a reduced supply of oxygen. The reason for this reduced intake can be very different, but should be treated and avoided in any case. However, a positive course of the disease cannot be guaranteed in every case. If the oxygen supply is completely interrupted, the person affected can also suffer irreversible damage to the internal organs or the brain. This may lead to paralysis or mental disabilities in the patient.

prevention

Depending on the cause of fainting, it can be prevented with various methods. Regular contrast showers, for example, can be helpful against circulatory fainting, but also sufficient fluid intake and doing endurance sports. If the first warning signs of fainting appear, unconsciousness can be prevented or delayed if the body muscles are consciously tensed or if the person concerned sits on the floor. With anxiety, good and soothing coaxing and distraction from the anxiety-provoking factors can help.