Syncope

What are the symptoms of syncope?

Syncope is an acute hypotensive episode, resulting in transient global celebral hypoperfusion and loss of consciousness, which usually leads to loss of postural tone and falling. Secondary injury can result in significant harm

Symptoms include:

• light-headedness

• nausea

• vomiting

• sweating

• trismus

• brief twitching or convulsion

What are the different types of syncope?

1. Orthostatic syncope: occurs when standing up after sitting or lying down for an extended period of time in the dental chair

2. Vasovagal syncope: occurs as a reaction to pain, anxiety or fear, during or after a dental procedure

3. Other tyoes include volume depletion and heart arrythmias.

   
   

What is the management for syncope?

If the patient feels faint

1. Stop dental treatment

2. If the patient is in the dental chair, tilt the chair back to a horizontal position. If the patient is not in the dental chair, ask the patient to lie down. The seated position is not adequate for patients with syncope.

3. Raise the patient's legs.

4. Measure the patient's heart rate.

5. Assess consciousness by talking to the patient.

If the patient loses consciousness

1. Stop dental treatment

2. Raise the patient's elgs and try to achieve a position where the head is lower than the heart. If the patient is in the dental chair, tilt the chair to a horizontal position.

3. Measure the patient's blood pressure and heart rate.

Consciousness usually returns rapidly. Allow patients to recover slowly under supervision. Do not discharge them prematurely from care, particularly if they will be driving. If possible, check standing blood pressure. Check the patient can stand unassisted and without recurrence of symptoms. Consider referring for medical evaluation if the patient is elderly, recovers slowly or ahas repeated episodes of syncope without obvious triggers.

If the patient does not regain consciousness, consider other causes of syncope or collapse and :

• Call 000

• Start basic life support

• Place the patient on their side

• Maintian treatment until the patient gains consciousness or assistance arrives.