First Emergency Scare

Specialties School

Published

So I had my first real emergency scare in the school nurse setting. A fifth grade student walked into my office with a very small paper cut (and minimal blood) requesting a band aid. I finished putting a band aid on her and she then said she did not feel good. I asked her what was wrong and she said she had a headache. I asked herif anything else was bothering her and she said no. Unfortunately, I did not realize what was happening, and I checked her temperature which was normal. As I was putting the thermometer away, she fainted and fell backwards hitting her head and started to have seizure like activity for about 10 seconds. No history of seizures and no past medical history that we knew of. Her pupils were very dilated. She stopped and came to and started crying because her head hurt of course. We had her lay there. She was dazed, but knew her name, who the principle was, and where she was. I yelled for someone to call 911 as soon as the seizure like activity happened. The paramedics came and took her vitals which were normal. Of course, they doubted there was a seizure. Mom came and said she has fainted before from seeing blood. And she did say afterwards that the blood made her feel queasy. She did take her to the ER though. I did some research and apparently this is called vasovagal syncope and can cause what looks like a seizure, but really is not a seizure? Just wondering if anyone else has seen this, especially in the school setting? What did you do? I have seen NUMEROUS seizures in the hospital setting on a psych unit. Both epileptic and pseudoseizures.

So, is it still "vasovagal syncope" if it is pure psychologial onset? Eg. merely thinking of blood leads to fainting).

Or does there need to be a tangible trigger to be classified as "vasovagal."

Also, I personally am completely unfazed by live open thoracic surgeries, cadaver labs, blood draws, etc. So why do I repeatedly get serious vertigo when I see awake/talking women getting Nexplanon BC inserted during my FP clinic days? What gives? :confused:

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Specializes in Medical/Surgical/Telemetry RN.

This happened to one of my friends who got a cut on his finger and fell back and hit his head on the concrete. I was curious why this happened to him and my nursing professor told me its due to vasovagal syncope. Pretty neat stuff though.

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Specializes in School Nursing.

Thank you for sharing with us. Reading about health office scares and the outcomes is really helpful to me as I am still new and anticipating all kinds of emergencies. I know blood can make people faint but the seizure-like presentation would have scared me as well.

(I had my own first school emergency last week--a broken arm, not LOC, but I've never had such an adrenaline rush in my life :eek:)

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(I had my own first school emergency last week--a broken arm, not LOC, but I've never had such an adrenaline rush in my life )

It is a big adrenaline rush! I remember the first time I had a kid break a bone! Came to me from PE with an extra bend in his arm. He was in shock. Held it up and said "Uh, I hurt my arm" and I said "Well, you broke that arm. Ever been in an ambulance? Because today is your lucky day..."

I think I'll start a spin off thread...

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Specializes in School Nursing.
It is a big adrenaline rush! I remember the first time I had a kid break a bone! Came to me from PE with an extra bend in his arm. He was in shock. Held it up and said "Uh, I hurt my arm" and I said "Well, you broke that arm. Ever been in an ambulance? Because today is your lucky day..."

I think I'll start a spin off thread...

Wish I could say I was as calm as you! As I pulled up his jacket sleeve and started to see the bend, my heart was thudding all the way up in my head and I just kept telling him he was brave. As I splinted his arm and tried to keep him alert and calm I was totally also working on myself :nailbiting:

(I am glad you started a spin off thread, which I am totally stalking!)

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I have this when my Crohn's is really painful, BP drops, I of course stand up to get off the toilet so I don't pass out in a bathroom, and I make it a few steps before I am out like a light. My husband says I just lay there with my eyes open, unfocused, and non responsive for like less than 30 seconds. He puts my feet up on a chair or something else, this helps and I recover faster. Its super annoying and embarrassing when out in public lol. Glad your student is ok!

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Specializes in Cardiac (adult), CC, Peds, MH/Substance.

Psychological versus physical precursor doesn't preclude vasovagal connection. Both can be causal, much like hypertension can have either trigger. People react differently to stressors. The vagal nerve is simply the mechanism of transmission that transmits the initial stimulus. Generally, the stimulus is in some way unpleasant. It can be hunger, constipation, or the sight, smell, or other sensory input of something unpleasant (scent of vomit, sight of blood, anatomically unusual sights, etc).

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Specializes in NCSN.

I never heard of this before and I'm fascinated!

This forum is the best :)

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