Fainting or passing out can be disturbing, not just for you but for the people around you. However, it isn’t necessarily the sign of a medical emergency.
The technical name for loss of consciousness is syncope (sing-koh-pee), and it accounts for about 3% of emergency room visits and around 6% of hospital admissions. Let’s dive in to what causes fainting and the signs that could indicate someone is about to faint – plus when you should seek emergency care.
What Is Fainting or Passing Out?
Fainting, passing out, or syncope means you lose consciousness for a short time, usually a few seconds or minutes. Most fainting spells are pretty short — some people regain consciousness before they fall down.
In most instances, the individual who passes out wakes up and returns to normal. Loss of consciousness can look like shaking, trembling, shuddering, seizing, or a sudden collapse.
Very rarely a prolonged syncope episode can lead to a seizure. Still, a majority of the time, the person wakes up quickly and can resume their normal activity.
What Causes People to Pass Out or Faint?
Loss of consciousness is primarily caused by a sudden drop in blood pressure, which reduces the flow of oxygen-enriched blood to the brain. Reduced blood pressure can occur for many reasons. For some, a needle stick is all it takes. Hyperventilating (breathing too fast) can also cause people to pass out.
Types of syncope include:
- Cardiac syncope is due to a heart problem like irregular heartbeat or poorly performing heart muscle.
- Carotid sinus syncope happens when the carotid artery in the neck is constricted or pinched.
- Situational syncope includes bodily movements or functions that can cause a natural drop in blood pressure and lead to passing out.
- Vasovagal syncope is the most common and includes the needle stick mentioned above.
People with cardiac insufficiency or who have various types of irregular heart rhythms sometimes faint because the heart is not pumping blood well enough to reach the brain, causing cardiac syncope.
Carotid sinus syncope is what you get when someone “chokes you out.” However, it also occurs if you wear a tight collar, stretch or turn your neck too much, or a bone in your neck pinches the artery. Long ago, men who wore high collars made of celluloid or heavily starched linen sometimes passed out because the collars were too tight or pinched off the carotid artery.
Situational syncope can sometimes be embarrassing because it can happen during urination, defecating (pooping), coughing, or stretching. However, you probably need to strain pretty mightily if you lose consciousness during most of these activities.
For some people, inflammation or pain in particular nerves in the mouth can cause loss of consciousness. Visits to the dentist or eating certain foods might present a problem.
Vasovagal syncope happens due to stress and is most commonly seen in children and young adults. It can occur due to:
- The sight (or thought) of blood
- Emotional stress
- Physical or emotional trauma
- Pain
What happens is that the stress stimulates a bodily reflex called a vasovagal reaction. The heart slows down and pumps less blood, blood pressure drops, the brain doesn’t get enough oxygen, and the person faints.
Warning Signs and Symptoms That You Might Be About to Pass Out
Most people have one or more of the following signs that indicate they are about to lose consciousness:
- Feeling cold and clammy or hot and suddenly sweaty
- Appearing pale or flushed
- Dizziness or light-headedness (pre-syncope)
- Weak or nauseous
- Stressed out or anxious
- A slowing pulse
- Sudden difficulty hearing, like ringing in the ears
- Visual disturbances like whiting or blacking out or seeing “stars,” blurry or tunnel vision
- A blue tinge to the skin
- Frequent yawning
- Headaches
- Loss of muscle control
Again, none of these symptoms or the fact that someone faints isn’t necessarily a medical emergency. However, if you have certain health conditions or have been involved in an accident, a visit to the doctor’s office or even the emergency room may be required.
Diseases and Conditions That Can Contribute to Syncope
Diseases of the autonomic nervous system, which controls essential functions like your heart rate, how much your blood vessels constrict, and your breathing rate, can make you susceptible to passing out. These diseases include:
- Acute or subacute disautomia
- Ganglionic or pre-ganglionic insufficiency
- Other conditions resulting in erectile dysfunction, loss of bladder and bowel control or normal pupillary reflexes, or reduced sweat, tears, and saliva
Conditions that interfere with other parts of the nervous system can cause you to faint, including:
- Diabetes
- Alcoholism
- Malnutrition
- Amyloidosis (a waxy build-up in tissues and organs)
If you have heart or blood vessel problems that block blood flow to the brain can create the conditions for loss of consciousness, such as a heart block or problem with the electrical impulses controlling your heart muscle. It could also mean you have problems with the sinus node, the area of the heart responsible for helping it beat.
Heart arrhythmias, heart structure problems, and blood clots in the lungs can also cause you to pass out.
Some medications, illnesses, and activities can cause you to pass out. Skipping meals, becoming dehydrated, taking diuretics or calcium channel blockers or anti-psychotics, anemia, and migraines can make you suffer syncope.
Should you visit an emergency room or urgent care facility? What is the difference? Read more here.
When to Call 911 or Visit the ER
One fainting spell without complications probably doesn’t require a doctor’s assessment. However, if someone faints and any of the following apply, getting emergency help is a good idea:
- Diabetes
- Pregnancy
- Over 50 years old
- Bleeding or injury
- Unconsciousness for more than one minute
- Unable to clear throat or cough
- Chest pain, discomfort, or pressure
- Difficult speaking or cannot speak
- Confusion
- Tingling or numbness
- Cannot feel or move a limb
If someone is injured in a fall due to fainting needs to seek emergency services, especially if they suffer a head injury or fall from a height.
If you are with someone who loses consciousness and it is safe, take the following steps:
- Ensure the airway is clear
- Make sure they are breathing and they have a heartbeat
- Elevate the feet above the level of the heart
- Loosen any restrictive clothing
- Call 911 or seek immediate medical attention if required
When someone faints and wakes up quickly, encourage them to sit or lie down for 15 minutes or until the faintness passes. Make sure they aren’t injured. If someone feels like they might faint, have them sit and put their head lower than their shoulders or knees to help increase blood flow. A cold drink or ice can also help.
Wrapping Up
Passing out isn’t necessarily an emergency, but you should seek medical attention if it’s caused by injuries or illness. Come to Family First ER, where we have experienced medical staff who provide high-quality care for syncope or loss of consciousness.