Fainting and Dizziness

Hilliard Pediatrics, Inc. - Dr. Tim Teller, MD


Introduction


Fainting is when there is a brief loss of consciousness. It is often called “passing out” or syncope. Dizziness is when someone feels like they may faint or the room is spinning.

Fainting or dizziness episodes are common amongst children and they are most common in the 9-18 years of age range. Although the episodes can be scary, 19 out of 20 times they are “simple” fainting episodes that make sense in the situation. Fainting happens when not enough blood is getting to the brain. Although children can hit their heads as they fall, it is very unusual for simple fainting episodes to cause any other harm.


Common Causes of Fainting


These episodes are called “simple fainting”.

  1. Standing up suddenly after laying down for a while (such as sleeping).
  2. Standing in one place for a long time.
  3. Sudden stress (seeing something that shocks or frightens someone).
  4. Sudden or severe pain.

Things that make fainting or dizziness more likely:

  1. Not having enough fluids in your system.
  2. Not eating enough recently.
  3. The room being warm or hot and stuffy.
  4. An illness. 

Common Symptoms with Dizziness and Fainting


  1. Fast and hard heart beats.
  2. Stomach pain.
  3. Feeling hot but the skin is cool and clammy.
  4. Tunnel vision.
  5. Looking pale.
  6. If someone faints, they often start to recover within 15-20 seconds although someone may feel out-of-sorts for minutes afterwards.

What to Do When


What to Do If Feeling Dizzy or Faint
  1. Lie down with feet elevated for 10-20 minutes. You will get more blood to your brain by doing this rather than leaning over and putting your head between your knees.
  2. If fainting seemed to happen after not having enough to eat or drink, once your child is fully awake have them drink some fruit juice (orange, grape, or apple juice are fine). If you do not have juice, a lemon-lime soda (Sierra Mist®, Sprite®, and 7-Up®) is fine.
  3. In hot weather, have your child drink a few glasses of cold water and apply a cold washcloth to the forehead.
Times we should see someone in the office for an appointment

Note: Dizziness and fainting episodes are best handled with an appointment and not a walk-in visit in the office.

  1. Your child faints more than once on the same day.
  2. Your child fainted and still feels faint after one hour.
  3. Your child has fainting happen frequently.
Call 911 immediately after a Fainting Episode If:
  1. Your child is still unconscious or difficult to wake up after 2 minutes.
  2. The fainting is caused by choking.
  3. There is difficulty breathing.
  4. There is weakness, they are not moving well, or blue or gray skin color.
Times your child should be seen at the Nationwide Children’s Emergency Department
  1. If your child faints then is acting confused for more than 5 minutes after the episode.
  2. Muscle jerking or shaking during fainting episode.
  3. If the fainting followed a head injury.
  4. If the fainting followed an injury to the stomach.
Tests that we may order
  1. An EKG. This helps rule-out a heart rhythm problem and other heart issues (myocarditis or hypertrophy).
  2. It is very unlikely that checking any blood work that will tell us anything. Children that feel faint when their blood sugar dips will generally have very normal blood sugars when checked at any other time. The symptoms that make us worry about diabetes developing (drinking excessively, urinating more frequently, and losing weight despite eating more) will have us do some more investigating, though.
Your child will likely need to see the Pediatric Cardiologist at Nationwide Children’s Hospital if these issues are a concern
  1. The fainting occurred while exercising.
  2. There is a family history of heart rhythm issues (such as “long QT”).
  3. If we check an EKG and find a rhythm problem on the EKG. 

Prevention


  1. Eat a balanced diet with regularly scheduled healthy meals (especially breakfast) and snacks.
  2. Drink more water. Even if you feel you drink “plenty” or “enough” water, drinking more water helps prevent these episodes. Grade school aged children should try to drink two extra water bottles each day. A middle school or high school aged student should increase their water intake by four extra water bottles per day. We have had specialists have our patients increase their intake by 8 bottles of water per day!
  3. Eat more healthy salty snacks. These include pretzels and nuts (peanuts, pecans, almonds, etc.). The extra salt helps your system hold onto the fluids so will have more fluids in your system to help prevent the dizziness or fainting episodes.
  4. For those children that feel faint mid to late in the day, drinking more fluids is important. So is making sure your child eats a healthy breakfast with some protein (eggs, breakfast meat, peanut butter, etc.), eats a healthy lunch with some protein, and eat a healthy snack if they go longer than 3-4 hours without eating a meal. 

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