Wednesday, 25 March 2015

Medical: Vasovagal Syncope -- Girl Collapsed Before My Eyes!!!

Have you ever dealt with a fainted person?
This happened in early March, I was waiting outside a clinic for a doctor to check on my left ear (I had been having ear blockage for about 3 weeks and it was getting worse, with pain with every little pressure change and my hearing was down 80%) when a girl about 16 or so collapsed in a cross-shaped posture in front of me. The back of her head banged onto the floor and her mum couldn't get her up. All she could do was to sit on her daughter's lap, looking helplessly frightened as she hugged her daughter's powerless upper body.

Image from Oxford journals

Immediately I went over to drag her to the wall and away from the static crowd for a quick rest. She was at least as heavy as I am and her face as pale as sheet. Nurses at the clinic that I was waiting came out to check her up. Her mum said she just had her teeth scaled and stitches in her mouth removed, she also said she ate before the visit but the nurses gave her candies anyway. The nurses didn't inform the doctor. Maybe they would had the girl completely lost consciousness. The dentist came out soon after the girl collapsed and the mum asked him about the treatment her girl received. The dentist denied that there was anything to do with drugs or sedatives used and I believe so. He asked if the girl saw her own blood but the girl said no. After a few pats on her head telling her she will be okay, the dentist returned to his clinic and so did the nurses to theirs. The girl and the mum later moved to the sofas as they sat down and murmured among themselves.

I suggested her mum to get another adult to come in case she collapses again but her dad went on business trip and she had no relatives nearby, then I told her mum to give her a cup of water as she was sweating quite a bit, and make sure she get enough rest before leaving.

Running in my head were thought processes and questions of how this girl managed to collapse in free-fall style. There is a possibility that blood loss during dental scaling has weakened her, or that she might have had low blood pressure in the first place. She is a teenager, so blood loss during her period could be possible but that is something I cannot confirm. Blood loss is just one suspect. What I can confirm is that the teenage girl was taller than me and probably heavier than me, adding sudden sweating, complete loss of balance and consciousness, and regaining of consciousness after collapsing onto the floor, we get something called vasovagal syncope.

Definition from Wikipedia goes,

Vagus nerve
Image from Wikipedia

"A vagal episode or vasovagal response or vasovagal attack (also called neurocardiogenic syncope) is a malaise mediated by the vagus nerve. When it leads to syncope or "fainting", it is called a vasovagal syncope, which is the most common type of fainting. Vasovagal syncope is most commonly discovered in adolescents and in older adults."

I shared this incident with my uncle who happens to be an expert in emergency medicine, girls collapse often and vasovagal syncope is related to stress, pain, anxious, hunger and many others, may or may not due to amount of blood loss. I am not sure about her stress or pain level but she should be in good mood enough to get teeth scaling. People who feel very upset don't go to make their teeth look better, they will just cancel the appointment. Then again, even if it was because of pain and anxiety, nothing a doctor or I could do to help at that point.

After about 15 mins or so, the mother and the daughter decided to leave. I gave them a final reminder that they should both hold the handrails at the staircases when they leave the building and soon I was called to enter the room to see the doctor myself, who referred me to a specialist to have my earwax removed as he did not have the equipment to help me. I paid $360 in exchange for an eardrop and a referral letter, but that is another story.

murmur -- (vb)[I or T] to speak or say very quietly
vasovagal syncope -- (n)[U] please refer to definition in the passage

Vasovagal response @ Wikipedia

How to Deal With Fainting @  WikiHow