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Quick reference medical handouts used by Pediatric offices


Childhood Fainting Rarely Cause for Alarm


Have you ever wondered why some children suddenly "pass out" at the sight of blood or faint when they get excited? This temporary loss of consciousness (medically known as syncope) seems to happen in an instant. Actually, it is the last step in a long chain reaction that begins with a rapid drop in blood pressure resulting in decreased blood flow to the brain. Many factors produce this blood pressure drop--some serious, most not. Yet for a parent, seeing their child faint can be a terrifying experience.

Vasomotor or vasovagal syncope (syncope means sudden loss of strength) is a common cause of childhood fainting. It occurs in response to fright, stress, excruciating pain or the sight of blood. Vasovagal syncope is the reason some children pass out seconds after receiving an immunization at their pediatrician’s office. Becoming upset or frightened in susceptible youngsters stimulates an important structure, vagus nerve, which disrupts normal circulation. The heart rate slows and the blood that usually goes to the brain is pooled in the legs causing the child to faint.

The next most frequent cause of fainting is known as postural or orthostatic hypotension. It occurs when children get up quickly from a prone position or stand in one position for a prolonged time. As we change our posture, the nervous system organizes the heart beat and blood vessels to make sure the brain gets adequate circulation. In susceptible children, these changes are improperly orchestrated resulting in a rapid fall heart rate and blood pressure and a momentary decrease in blood flow to the brain.

There are other less common causes of fainting in children. When youngsters breathe too fast or too deeply (called hyperventilation) they can faint because the heart rate and blood vessels cannot keep up with the body’s need for oxygen. Most often, hyperventilation occurs when a child is under emotional stress, and the youngster frequently complains of chest tightness and light-headedness before passing out. Some children faint during or immediately following exercise ("exercise syncope") because their muscles attract most the body's blood. If enough blood is shunted from the brain, the child passes out. This type of fainting can strike healthy, well-conditioned athletes as well as sedentary children. Whatever the cause, the body seems to know what is best. Becomming horizontal on the floor restores blood flow to the brain and consciousness returns.

The faining episode usually starts with a "funny feeling" that is often accompanied by mild nausea, yawning, weakness and clamminess. Next, the child may notice sounds become fainter and fainter, followed by loss of consciousness and collapse. While unconscious, slight twitching or convulsive movements may be seen in the arms or legs. The fainting spell only lasts seconds to minutes. Upon waking up, the child may complain of a headache and be a little embarrassed, depending on where and how the youngster fell. Susceptible children should avoid those situations that cause them to pass out. In addition, it is a good idea to inform other health professionals caring for the child of this condiotion.

The best way to help a child who passes out is to stay calm. Brace their fall if possible and have them lie down with the legs elevated. If this is not possible, have them sit with their head bent below their knees. Applying cold compresses to the temples will help stimulate blood flow, but forget about throwing cold water on their face or smelling salts. The only time this works is on television and in the movies! Make the youngster comfortable and check carefully for injuries, especially if the child hit their head. If the youngster who has fainted is allowed to get up and walk about too soon, they may pass out again. Call "911" at once if the youngster does not regain consciousness within 3-5 minutes or appears to pass out again after being awake.

Rarely does a fainting episode mean the presence of more serious underlying disease. However, parents should consult their child’s physician if the youngster’s fainting is associated with any of these features:

* Irregular heart beat

* Shortness of breath

* Sudden onset (no warning signs)

* Blurred vision, numbness or tingling in any part of the body

* Confusion

* Fainting more than once in a month

* Difficulty in speaking or loss of arm or leg movement after the episode

* Loss of bowel or bladder control, or tongue biting drowsiness, or amnesia

* Medication or alcohol is suspected as a cause

If an otherwise healthy child has recurrent fainting spells that cannot be explained, the youngster’s physician may suggest medical tests to uncover another basis for the fainting. The good news is that serious medical problems account for a very small percentage of fainting spells in children.

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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