My friend lost her dad recently. During the burial, she cried a lot and collapsed half dead. We blew some fresh air over her using clothes and soon she recovered her consciousness. But she still complained of severe chest and stomach pain. What could have triggered this and what is the best first aid to give when a person collapses? 

Angel

Dear Angel,

I am extremely sorry for the loss of your friend’s father. Death of a parent is like a protective shade being removed, exposing a person to hot sun. It seems your friend had fainted during the burial.

Fainting is transient loss of consciousness due to temporary cutting of blood supply to brains. Four out of 10 individuals have fainted sometime in their lives. A person of any age can experience it. This can occur due to emotional stress, exposure to heat or dehydration. Low blood sugar levels, as may happen without eating or drinking anything for a long time, can also cause fainting. A person can also faint due to the blood pressure falling below normal limits (<90/60mm. Hg). This may happen due to not eating, diarrhoea and/or vomiting and effect of some drugs. Some people develop a low blood pressure, while standing for a long time as blood pools in legs and the return to heart via veins is not adequate. Wearing shirts/dresses with tight collars can also induce fainting.

People with varicose veins (dilatation of veins of legs) are also prone to fainting due to tendency of pooling of blood in legs. Severe blood loss due to trauma, fluid loss due to burns can induce fainting in a person. Among serious conditions, transient ischemic attack (T.I.A.) can cause fainting in a person. In this condition, there is sudden cutting of blood supply of brain due to a clot in one of the blood vessels of brain. There may be associated paralysis of one or more body parts, which resolves within 24-72 hours. High blood pressure, diabetes and high lipid levels are some of the risk factors causing T.I.A.

In a person who has suddenly become unconscious, pulse is usually fast and feeble. In extreme cases it may not be perceptible. Blood pressure recorded is below normal or there may not be a recordable blood pressure.

The immediate first aid for a person who has fainted is to elevate the legs about 12 inches or more from the ground. This improves the blood flow to the heart, which in turn improves output of blood from heart to rest of the body, improving pulse and blood pressure. The clothes should be loosened and any constricting item like watch, bracelet or belt should be removed. If the weather is hot, pouring some water over face or pushing some water from lips is useful.

In mild cases, first aid measures are enough to revive the person. If unconsciousness persists, it is recommended to shift the person to a hospital for further management in form of intravenous fluids, bolus of glucose, or other necessary measures.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital