It happens more frequently than people think.
One minute you’re standing there, the next minute you wake up with a crowd of people gathered around.
All you can think is “why are all these people staring at me”?
As unnerving as that is, the next question is “what the hell just happened”?
Then someone looks down and says “you just fainted”.
In a bit of a confused state you also start to become a little embarrassed. You lost control and have no memory of the last couple of minutes. You’re in a public place and all of these people staring at you (although they are genuinely concerned) and then the paramedics show up. Someone had called 911 and now there’s an even bigger scene going on.
Although you feel fine and everything is okay, your ego is a little bruised. It wasn’t that big of an emergency.
Fainting And Massage Therapy
We’ve all heard it before.
How are you feeling now that you’re up and moving around after your massage?
“Actually I’m a little light headed"
Most often this is caused by standing up too fast, or standing in one place too long (orthostatic hypotension) which causes a temporary reduction in blood pressure. Your patient has been laying down for an extended period of time and even though they’re relaxed, they’re in a hurry after their appointment to get on with the rest of their day and want to get going.
They walk out of the treatment room, the lights are bright and they just sprang off the table.
Now they’re a little dizzy and feeling a bit woozy.
Remember back in college when you had to take every new patients blood pressure before every treatment? Well here’s some of the reasons why.
When this happens there is a temporary drop of 20mmHg in a persons standard blood pressure. If you have a patient who regularly feels woozy when getting off the table, or they have a history of low blood pressure, you can do some blood pressure tests to see if this is what’s causing the woozy feeling.
Take the patients blood pressure while they are laying down. Leave the cuff on, then take their BP again while they are seated and again when standing. If the BP drops more than 20mmHg and pulse increases 10-20% or 15 beats per minute it’s a good sign of orthostatic hypotension (aka: postural hypotension). This test may have to be done at the start of a treatment as it would be hard to do while trying to keep someone draped properly on the table.
If this happens with one of your patients, where this reaction after the massage is not a common feeling (or they don’t normally have blood pressure issues), there could be some underlying issues that need to be looked at. The drop in blood pressure could be from bleeding in the stomach or intestines as well as various heart conditions.(1)
If you are unsure of the cause of their fainting spell, they should be referred to medical attention.
Other Reasons For Fainting.
In addition to orthostatic hypotension there are several other reasons someone in your clinic could faint.
• They are pregnant
• They receive some traumatic information (i.e: a death in the family)
• They haven’t eaten (which could also be some diabetic issues)
• Emotional shock
Whatever the cause of their fainting spell, a person should wake up after a minute or two.
If they don't wake up, you have a responsibility as a healthcare professional to take care of this person.
The first step is recognizing there is an issue and calling 9-1-1 to get some more advanced help on the way.
Now, to take care of this person until more help arrives.
First you must check the ABC's.
If the person is not breathing, then you have to start your CPR protocol, but for the purpose of this post we are going to say your person is still breathing.
Start by giving their traps a good squeeze to see if they respond (that part isn't in the video below).
Then assess their breathing. We do this by using a technique called "look, listen and feel" by putting your ear right above the persons mouth, while facing their chest with one hand on the chest or diaphragm.
You want to try and feel for their breath on your ear and watching for your hand to rise and fall with the chest, while the patient breaths.
Once you confirm they are breathing, you need to do a rapid body survey to check and see if there are any other injuries, as well as checking for medical alert bracelets which could give you a clue as to why the person fainted.
Now that you have determined there aren't any other injuries and there is no risk of a spinal injury, we need to maintain the persons airway by getting them in the recovery position.
This is demonstrated in the video below.
With there being so many reasons for someone to faint and for the sheer volume of people we see in our clinics, there is a distinct possibility that you will have to deal with something like this one day. Remember your responsibility as a healthcare professional is to be able to help and maintain anyone of your patients having a medical emergency in your clinic. Being able to properly maintain this persons airway until more help arrives is crucial to preventing their condition from getting worse. While it can be scary to deal with something like this, being prepared makes it a little less unnerving. Fortunately with your understanding of anatomy and physiology, you should be a pro at understanding the mechanisms of what's happening. And your patients will be more thankful than you can imagine.
(1) When should you worry about fainting?. Harvard Health Letter. (2015, Aug), [cited March 7, 2017]; 40(10);6. Available from: Biomedical Reference Collection: Comprehensive.
Meet The Author
Jamie is a RMT and volunteer firefighter in Victoria BC. During his career Jamie has focused much of his practice into sport, but also works in a clinical setting the majority of the time. In 2015 Jamie launched "The Massage Therapist Development Centre" which is a collaborative blog to increase the perception of the great things massage therapy and massage therapists do.