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Syncope: Treatment The treatment of syncope is directed at the underlying cause. This discussion will focus on disorders of autonomic control. Arrhythmias are discussed in Chaps. 225 and 226, valvular heart diseases in Chap. 230, and cerebrovascular disorders in Chap. 364.Certain precautions should be taken regardless of the cause of syncope. At the first sign of symptoms, patients should make every effort to avoid injury should they lose consciousness. Patients with frequent episodes, or those who have experienced syncope without warning symptoms, should avoid situations in which sudden loss of consciousness might result in injury (e.g., climbing ladders, swimming alone,. | Chapter 021. Syncope Part 7 Syncope Treatment The treatment of syncope is directed at the underlying cause. This discussion will focus on disorders of autonomic control. Arrhythmias are discussed in Chaps. 225 and 226 valvular heart diseases in Chap. 230 and cerebrovascular disorders in Chap. 364.Certain precautions should be taken regardless of the cause of syncope. At the first sign of symptoms patients should make every effort to avoid injury should they lose consciousness. Patients with frequent episodes or those who have experienced syncope without warning symptoms should avoid situations in which sudden loss of consciousness might result in injury e.g. climbing ladders swimming alone operating heavy machinery driving . Patients should lower their head to the extent possible and preferably should lie down. Lowering the head by bending at the waist should be avoided because it may further compromise venous return to the heart. When appropriate family members or other close contacts should be educated as to the problem. This will ensure appropriate therapy and may prevent delivery of inappropriate therapy chest compressions associated with cardiopulmonary resuscitation that may inflict trauma.Patients who have lost consciousness should be placed in a position that maximizes cerebral blood flow offers protection from trauma and secures the airway. Whenever possible the patient should be placed supine with the head turned to the side to prevent aspiration and the tongue from blocking the airway. Assessment of the pulse and direct cardiac auscultation may assist in determining if the episode is associated with a bradyarrhythmia or a tachyarrhythmia. Clothing that fits tightly around the neck or waist should be loosened. Peripheral stimulation such as sprinkling cold water on the face may be helpful. Patients should not be given anything by mouth or be permitted to rise until the sense of physical weakness has passed.Patients with vasovagal syncope should be .
