Care and mobility considerations

Fainting, by definition, results in a transient period of unconsciousness and therefore carries a degree of risk of injury from falling or the effects of losing consciousness while in a potentially hazardous situation such as when driving or working at height.

However, a simple faint is usually an isolated episode and should not result in the need for restriction of activities or any specific help or supervision out with that needed at the time of the attack. Simple faints can occur repeatedly in susceptible individuals, usually in predictable situations and even so should not result in a functional abnormality. Solitary episodes of fainting with no evidence of an underlying cause would not result in restriction of driving.

Where attacks are frequently recurrent as in situational fainting, or where they are associated with significant underlying disease, the risks of harm and the need for help or supervision will need to be considered based on the more general guidelines for assessing episodic loss of consciousness. Continued frequent attacks of fainting may well impact on quality of life and perceptions of well-being.

In a study of a large series of cases the incidence of serious injury such as fracture was 6% and that of minor injury such as abrasion or bruising was 29%.

Fainting poses an accepted risk for frail elderly people due to age related physiological changes in heart rate, blood pressure and cerebral blood flow, as well as the effects of co-existing conditions and is commonly associated with falls. The incidence of fainting is 6% in the older adult (>70 yrs) with a prevalence of 10%, although these figures may underestimate the risk as incidents of falling may not be reported as fainting.

Where there is underlying disease the functional effects of that condition would need to be evaluated in their own right.

Variability

The condition is episodic and therefore inherently variable. In simple fainting there should be no impairment of function between episodes and any difficulties are limited to the immediate period of the episode. When fainting accompanies an existing condition the ongoing effects of that condition will influence any variability.