Vasovagal Syncope Management — MFDS Part 1 MCQ

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EasyHuman DiseaseVasovagal Syncope ManagementMFDS Part 1

During dental treatment, a patient becomes pale and sweaty and briefly loses consciousness. They are breathing normally, and vasovagal syncope is suspected. What is the most appropriate immediate positioning?

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Correct answer: E — Lay the patient flat and raise the legs

The correct answer is E. After stopping treatment and assessing the patient using an ABCDE approach, a patient with suspected vasovagal syncope who is breathing normally should be laid flat with the legs elevated. This improves venous return and cerebral perfusion; tight clothing can also be loosened. Recovery is usually rapid, and oxygen is not routinely required. Sitting the patient upright can worsen cerebral hypoperfusion. Intramuscular adrenaline is used for anaphylaxis, while sublingual GTN is used for suspected angina and may further reduce blood pressure. Intravenous atropine is not routine initial treatment for an uncomplicated vasovagal faint. Failure to recover promptly should trigger reassessment, consideration of another diagnosis and escalation as appropriate.

Reference: Scottish Dental Clinical Effectiveness Programme Practice Support Manual, Medical Emergencies in the Dental Practice, syncope section, May 2020. https://www.psm.sdcep.org.uk/media/3hlkptix/medical_emergencies_in_the_dental_practice.pdf