VITAL SIGNS
Techniques: A Way to Keep Fainting at Bay
By JOHN
O'NEIL
study released yesterday has some advice for people prone to
fainting: cross your legs and squeeze.
Fainting occurs most commonly when the brain sends a signal that
opens blood vessels wider, lowering blood pressure and causing blood
to flow away from the brain and into the legs. The signal also slows
the heart, in turn reducing the flow of oxygen to the brain. In some
people, the signal, called the vasovagal reflex, is set off by
emotional stress; in others, by prolonged standing.
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Researchers from the Academic Medical Center in Amsterdam decided
to see whether fainters would benefit from a technique developed for
people with a condition that causes their blood pressure to drop
when they stand up.
The technique is simple: when the patients felt lightheadedness
approaching, they crossed their legs, putting one ankle over another
in what the researchers called the "cocktail party stance." They
then tensed the muscles in their legs, buttocks and abdomen, forcing
blood out of the legs and toward the brain.
In the new study, 20 patients who had suffered fainting spells
were trained in the technique and strapped onto a tilting table.
They were left upright for 20 minutes, and those who had not become
lightheaded by then were given nitroglycerine, which opens up blood
vessels, to speed the process.
Using the cross-and-squeeze maneuver stabilized the blood
pressure and the heart rate in all the patients. The five patients
who began the technique the most quickly when their blood pressures
began to fall did not faint; in the others, the technique delayed
the loss of consciousness by more than two minutes. Those minutes,
the researchers noted, give the victims time to find a place to sit
or lie down.
Nineteen of the patients were interviewed seven to 14 months
later. Thirteen reported using the maneuver regularly to prevent
fainting, and only two reported fainting spells in that time.
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