Vasovagal Syncope — ORE Part 1 MCQ

Correct answer: C — Lie the patient flat and elevate the legs

The correct answer is C. In uncomplicated vasovagal syncope, place the patient supine and elevate the legs to improve venous return and cerebral perfusion. NHS advice for a person who has fainted is to lay them on their back and raise their legs. Sitting upright may prolong or worsen cerebral hypoperfusion, and oxygen is not routinely required if breathing is normal. Intramuscular adrenaline is for anaphylaxis, not a simple vasovagal episode. Intravenous fluids are not first-line management for an otherwise healthy patient with a brief uncomplicated faint. A 999 call is indicated if the patient is not breathing, cannot be roused within 1 minute, does not recover fully, or has other concerning features; it is not the immediate routine response to a promptly resolving simple faint.

Reference: NHS. Fainting. Last reviewed 23 February 2023. https://www.nhs.uk/symptoms/fainting/