Fainting on Holiday
28th February 2023 | Dr Melanie Dani
Introduction
The syncope team are often asked about how to avoid fainting on a trip away or holiday. In the first of two companion posts, the syncope nurses explore the likely reasons for one woman’s holiday faint.
Barbara’s Holiday Faint
“Barbara” and her husband “Tom” had been looking forward to their break to a destination they had always wanted to visit as part of a celebration of their 25th Wedding Anniversary. On the first evening there, Barbara fainted. She suffered some facial injuries in the fall. Barbara was left sore and reluctant to go out to ‘show off her bruises’. She had been worried that people might assume that she was drunk and fell or else that Tom had been responsible for the bruises! Tom had been very worried that she might collapse again and looked into cutting short their break to have her collapse investigated. Hardly the romantic and much anticipated trip that both of them had planned.
Barbara and Tom’s visit to the syncope nurses provided even more important details:
After a busy week trying to clear her desk at work and some last minute packing Barbara and Tom set off for the airport. They left a bright and pleasantly warm London and felt as though they had ‘walked into an oven’ when they left for their hotel on arrival. After a fitful night’s sleep, they spent their first day sightseeing and visited a hill top tourist site on foot just before lunch. Barbara had a glass of wine with lunch and then returned back to the hotel. Tom took a nap but determined to make the most of her time away, Barbara decided to read by the pool until dinner. She had sunscreen, a glass of ‘something fruity with an umbrella in it’ and some cola. Later that evening they waited at a very popular restaurant bar for a table. Barbara was developing a bit of a headache, felt a little nauseous and felt that the crowded bar was becoming too hot as she sipped her diet cola. She stood and planned to walk out for some fresh air before feeling dizzy and losing consciousness. Unfortunately she caught her face on the edge of the bar before falling onto a tiled floor. A trip to the emergency room followed.
So why do we think Barbara fainted?
Barbara’s story highlights many common causes of faints on holiday and things to avoid- especially if you know that you have vasovagal syncope.
– FATIGUE
• Long hours at work preparing for her time away from the office, holiday preparations
• A long day of travel before with poor sleep
• A very active first day sightseeing
– DEHYDRATION
• A sudden change in climate
• Sightseeing on foot at midday
• Mainly caffienated and alcoholic drinks. Little water
• Sunbathing
– BLOOD POOLING
In a fatigued and dehydrated state, blood pooled whilst Barbara was seated for a while in a hot and crowded venue.
Barbara did have warning signs of nausea, a ‘heavy head’ and the need for fresh air/getting hot. However, she did not recognise the signs of blood pooling and a falling blood pressure. Instead of taking evasive action she stood up and walked away- which resulted in even more blood pooling away from the brain and she fainted.
Conclusion
To avoid such incidents while traveling, especially for individuals prone to vasovagal syncope, it is crucial to prioritize rest and avoid excessive fatigue before embarking on a trip. Staying well-hydrated, especially in hot climates, and balancing alcohol and caffeine intake with sufficient water consumption is vital. Engaging in moderate activities and avoiding prolonged exposure to heat can also help prevent blood pooling. Additionally, recognizing the warning signs of an impending faint and acting promptly, such as finding a cool and comfortable place to rest, can significantly reduce the risk of accidents and injuries.
