Usually a vaso-vagal attack due to fright, Bad news, sudden pain or exertion in sun.
During an attack. Make the patient recumbent, and Flat on the ground. Loosen clothes around the neck and raise the legs. Feel the pulse to note the rate, rhythm and volume. Stimulate by splashing water or with strong smell (onion). Do not allow him to stand suddenly. Ask about chest pain, Limb paresis, slurring of speech and H/o. Diabetes, Hypertension and Angina.
If the patient does not wake up and become normal in 5 to 10 minutes, think of other cause and shift to Hospital.
If known diabetec, give I.V. 4 amps. 25% glucose. If chest pain/ sweating/ Low volume pulse. IV 5% dextrose. Inj. Mephentin 2cc IV. Inj. Efclorin 1 vial IV S.O.S. Refer to hospital or cardiologist for ECG. If he has black loose stools and pallor-? G.I. Bleeding. Refer immediately. If slurring of speech or weakness of one side-? Stroke.
Subsequent treatment of simple syncope:
Inj. Neurobion 1 amp IM daily x 5 injections. Cap. Becosules 1 bd x 15 (2C) Ask for Hb, ECG, X-ray cervical spine, X-ray chest. Treat Anemia, Cervical spondilitis if present.
If Postural Hypotension, (fainted while getting up from lying position)
Teach the patient to stand up slowly. Elastic stockings to both legs. Tab. Wysolene 1 bd x 10 -15 days. If taking treatment for Hypertension. Reduce the dose, or if necessary change the drug. Do not give steroids.
In Specific circumstances
Think of cough syncope, micturition syncope, and Hypersensitive carotid sinus.
After giving injections that cause sedation, like siquil, avil or calmpose, do not allow a patient to walk hoe alone he may faint and fall in the way.
