Fainting Safety

1. Fainting Safety By Cadets…For Cadets Presentation prepared by NVWG Cadet Safety Officer (C/SE) Grateful cooperation of the Las Vegas Composite Squadron and Nevada Wing CACs Encouragement and support of: Squadron Commander, NV-070 and the Nevada Wing Commander

2. A formation of Civil Air Patrol cadets, like these from the 2011 summer encampment in San Diego, CA, is MOST impressive! They are always best when there are no distractions due to fainting. This graduation parade was flawless!

3. What This Isn’t - This is not medical advice - This is not a full discourse on the causes of fainting - This does not replace sound medical consultation after fainting

4. What this Is A primer… An attempt to prevent one kind of fainting related to prolonged standing, such as in routine formations, drill competitions, special events, etc.

5. References http://www.emedicinehealth.com/script/main/hp.asp http://www.medicinenet.com/script/main/hp.asp http://www.mayoclinic.com/health-information http://www.ncbi.nlm.nih.gov/books/nbk224/ http://en.wikipedia.org/wiki/Vasovagal_episode http://www.rightdiagnosis.com/sym/syncope.htm

6. Definition Fainting - Medical Name: “Syncope” - Pronounced: “SIN-ko-pee” - AKA: Blacking Out, Passing Out Defined as “Syncope is a sudden, brief loss of consciousness associated with loss of postural tone from which recovery is spontaneous” – Dr. Sergio B. Seoane

7. Causes There are many conditions that can cause syncope. Therefore, this presentation can not possibly cover them all. http://www.rightdiagnosis.com/symptoms/syncope/causes.htm

8. Causes Broadly speaking, there are at least five basic categories of syncope - Cardiac - Neurological - Postural - Vasovagal - Other

9. Causes Some Cardiac (Heart) causes include: Abnormal heart rhythms Heart valve abnormalities Blood pressure problems Aortic dissection Cardiomyopathy

10. Causes And other medical causes such as: - Neurological involve the nervous system - Postural result mostly from sitting or lying to standing up too quickly - Vasovagal involves much of the rest - Other contributing factors to syncope (e.g. diabetes, emphysema, etc.)

11. Causes Some of the other cause that are not cardiac or vasovagal could be the result of… Postural hypotension High altitude Dehydration Stroke Heat Medications Low blood pressure

12. Causes Vasovagal (situational) syncope can result from… - Drawing blood - Urinating - Defecating - Swallowing - Coughing - Scary situations - Embarrassing situations

13. Causes This presentation will only cover the likely cause of one type… Vasovagal Syncope

14. Causes “Vasovagal syncope occurs when your body overreacts to triggers, such as the sight of blood or extreme emotional distress. The trigger results in vasovagal syncope — a brief loss of consciousness caused by a sudden drop in your heart rate and blood pressure, which reduces blood flow to your brain.” ~ The Mayo Clinic

15. Causes In layman's terms, with regard to vasovagal syncope, then… Locking the knees causes the blood flow to be cut. The circulatory system is basically a closed system, and by pinching off the artery to the legs, it disrupts that flow, which then lowers the blood pressure, cuts off the supply of blood to the brain, and one passes out due to loss of oxygen to the brain.

16. Consequences Those who pass out risk injury to themselves and others. This has cost personnel money, missing teeth, broken bones, lost blood, stitches, medical expenses, legal expenses, etc., not to mention a lot of embarrassment.

17. Symptoms - You may or may not have symptoms before you faint. - If you do have symptoms, they may include: Lightheadedness Shakiness Blurred vision See spots Tunnel vision Warm sensation Weakness/Fatigue Nausea - Others may see in you: Paleness Dilated pupils Sweating Wavering on feet

18. Symptoms Once you faint (pass out) others may notice a lower pulse rate of less than 60 beats per minute.

19. Prevention What can you do as an individual to help prevent fainting? - Be well hydrated long before you will stand at attention, drinking water - Have balanced electrolytes -- Enough to replace those you loose - Don’t lock your knees -- Move knees slowly, forward and back - If you feel fainting coming on -- Tell someone around you -- Sit down immediately! Do not be concerned with Staying in formation or how it looks! SIT DOWN Immediately

20. What Leaders Do • Tell cadets to drink more fluids and have an electrolyte drink well before coming to such events • Have cadets drink more when showing up for events • Warn cadets of the dangers of fainting by locking their knees • Remind them every 10 minutes or so • Keep cadets at Parade Rest, Rest, or At Ease if going to be in formation for long periods

21. What Leaders Do - Do not keep cadets in the sun for long periods - Consider having them fall out and reassemble later - Advise cadets to tell someone if they feel symptoms coming on If you feel faint, sit down immediately! - Advise all to pay attention to warnings and signs of those getting ready to pass out, and that it is not only important that one or two people move to help, but that helping is absolutely expected!

22. What Leaders Do - As soon as you are aware someone has fainted, direct someone to their attention - Have a person dedicated, for every formation, to be the “rear guard” and be the one to render care if someone faints - Advise those that stay in formation to fill in ranks of the missing person in a professional manner - Ensure key information is collected for required safety reports and up-channel as required

23. What Leaders Do Leaders in Civil Air Patrol have no greater charge than the safety of the personnel under their command and supervision. Do not fail in this responsibility!

24. Safety Forms • When a cadet faints, someone is going to be doing paperwork! • Review CAPR 62-2, Mishap Reporting and Review about Bodily Injury and mishap reporting requirements. • Also review Region and Wing supplements that may be pertinent to you • An Online Mishap Notification (Steps 1 and 2) must be completed within 48 hours

25. Locking Knees The distance between locked and unlocked is about 3-6 inches. Not Locked Locked

26. Locking Knees Slowly, alternate moving one knee forward, then the other, by lifting the respective heel. No one can tell you are doing this when wearing pants or in BDUs.

27. Save Yourself If you feel like you will faint, step out of formation or at least drop down to a knee.

28. Catch A Cadet If you see someone falling back we expect you to help catch them! A no-brainer!

29. Catch A Cadet Bigger cadets may need more than one person to assist. Watch out for their heads.

30. First Aid Assess their condition. It might be more serious than just fainting. Treat for shock. Treat for “Shock” I double our cadets are trained to give IV Fluids, etc.Leave this sentence out please.

31. Questions? You have now completed this module on fainting, please go back and take the quiz for safety education credit. Thank you for taking time to increase your awareness on a topic that CAP members can be faced with. Remember: Safety is a HABIT that only YOU can positively control!