Fainted "Syncope"

By Thomas Sim, 17 Sept, 2008

"Syncope" is pronounced as "Syn-co-pi", not "Syn-cop". From Wikipedia, it is pronounced as "sɪŋkəpi" and carries the medical meaning of loss of consciousness, or blacking out caused by the Central Ischaemic Response. Central Ischaemic Response is a more scientific way of saying the same thing. Nevertheless, we should understand the science behind it and thus, will be explained later.

'Fainted' is a layman term to describe this sudden loss of consciousness or 'black out'. The common reason leading to that is lack of sufficient blood and oxygen in the brain. The initial symptoms a person feels before fainting are dizziness; a dimming of vision, or brownout; tinnitus; and feeling hot. Moments later, the person's vision turns black, and he or she drops to the floor (or slumps if seated in a chair).

In YouTube, you are bound to find a few celebrities and contestants (Miss World or Miss Universe) passing out in front of crowds on stage or during Q&A session of a reality show. Although joke provoking, it is still a life and death situation.

This is why we need to understand the term - Central Ischaemic Response. Ischaemia - which means "situation when cells are deprived of oxygen" is a dangerous phenomenon in stroke and heart disease. Ischaemia may occur in the brain or any tissue which is deprived of oxygen. If it occurs in the heart, it is ischaemic heart disease - which may be described as Chest Pain, or Myocardiac Infarction (MI)- heart attack! When ischaemia happens in the brain, brain cells die and permanent death of cell in the brain would lead to paralysis of neuromotor function. That is why people who had stroke cannot talk or move body parts.

During a stroke, blood vessel(s) in the brain burst and blood supply to the brain is compromised. Some part of the brain is thus deprived of oxygen. The area which is ischaemic will die and result in non-functioning of the brain cells, shutting down the alertness and motor function of the body.

When an episode of loss of consciousness occurs, it is an emergency! What next?

Call for help! We are not paramedics or doctors, so don't pretend to be one. Next, check if the sufferer is breathing by listening to his nostrils, or by observing his chest movement. If the sufferer is lying on the ground, clear any obstacles or dangerous objects nearby in case of subsequent dangers. Give him air (which is bigger space), and allow the blood flow to the brain by leaving him flat on the ground. If you are familiar with checking the pulse, do so.

If he is not breathing and you can't feel the pulse, or heart beat, he is in great danger! Do CPR - cardiopulmonary resuscitation. Clear the airway by tilting the head up a bit, blow into the mouth, and see the lung being inflated. Then, count 1, 2 ,3 as you press your palms on the chest rips to expel the air. Like what you see in the movies, repeat doing CPR until the rescue arrives or the sufferer starts breathing on his own. If their is no sign, and you don't want to do mouth-to-mouth, at least massage the chest to stimulate possible response of breathing function.

CPR is unlikely to restart the heart, if it is really the heart that has already failed, but rather its purpose is to maintain a flow of oxygenated blood to the brain and the heart, thereby delaying tissue death and extending the brief window of opportunity for a successful resuscitation without permanent brain damage.

If the sufferer does not wake up. Please do not try to feed him. This is because you don't want to choke him with fluid or food. On gaining consciousness, do raise him up against a gentle support and clear his throat. Now, some fluid would be beneficial as most people experienced syncope due to dehydration. Replenishing fluid and sugar would be helpful but to be done slowly. Clear the surrounding space for more fresh air or move him to a open space.

He may be sweating wet (which is a common scenario), so getting cold and losing heat. You may want to change his clothing or add cover to him to preserve warmth. Always remember to ask if he is feeling any pain when he first gains consciousness. As we all know, angina or MI (heart attack) do present with pain radiating from the arms or at the chest.

By this time, the paramedic should have arrived. Leave to the experts to do their job. You have done yours, and that could have already saved his life!