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Syncope (Fainting)

Syncope (fainting) is a brief loss of postural tone followed by a spontaneous and complete recovery. It is often caused by a decreased blood flow to the brain, usually from low blood pressure. It may be due to severe pain, strong emotion, urination, defecation, vomiting, swallowing, or carotid sinus stimulation. Syncope may also be a sign of underlying disease, especially if symptoms do not resolve.

The patient may report prodromal symptoms such as dizziness, vision changes, warmth, lightheadedness. A fainting episode may be accompanied by twitching or seizure-like activity, which is not a seizure.

Treatment is to lay the patient flat, elevate the legs, make the patient comfortable (shade, out of the cold, etc.) and to complete a PAS. Assess for residual signs and symptoms.

Most syncope is benign and resolves promptly without further symptoms. Sometimes syncope suggests an underlying medical problem and in these cases this patient should be evacuated. We want to evac syncope that occurs during exertion; that occurs without the presence of prodromal symptoms such as dizziness, lightheadedness, pallor, diaphoresis, vision changes; and where there are residual signs and symptoms. Rapidly evacuate all events of syncope that are accompanied by chest pain, headache, SOB, abdominal pain, known pregnancy, or with signs and symptoms of shock.

These curricula recommendations have been adopted from NOLS Wilderness Medicine and have been edited to conform to the standards
set by Center for Wilderness Safety and the Wilderness Medical Society in accordance with the WMS National Practice Guidelines.

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