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When patients lose consciousness in the clinic, the most common cause is fainting. This is caused by a lack of blood to the brain. Fainting can be a result of hunger, fatigue, overheating, or it can occur after receiving local anaesthetic containing adrenaline (epinephrine)

A patient must be observed for several minutes after being given a local anaesthetic to ensure that none has been injected into a blood vessel. If a patient is lying flat in a chair, the likelihood of fainting is reduced.

A patient's skin appearing pale is often the first sign that a patient may faint. They may say they feel unwell, or that they feel nauseous. Do not put the chair up, lay it as flat as possible with their feet higher than their head to help increase the blood flow to the brain. Cool the patient if possible, and reassure them. If they do lose consciousness, it will only be for a few seconds. Sometimes the patient may make small movements and there may be tightening of the muscles.

Elderly patients who have been lying flat for some time should stay seated for several minutes after you have put the chair upright. This ensures that their blood pressure can adjust to standing up and get enough blood to the brain. Very nervous and anxious patients need to be observed for 10 minutes after leaving the chair as the high levels of adrenaline that their body has produced could cause them to faint when they stand up and move about.

Take particular care if they want to go immediately to the toilet; if they feel nauseous, they may faint in a locked toilet. If a patient faints in a public area, lay them flat, place them in the recovery position, and ensure their airway is open using the chin lift. Loosen any tight clothing around the neck and check their pulse; if they do not recover within a few seconds, get help and check for signs of life and re-assess the situation.