Hyper vagal response?

kimtab · Sep 7, 2005

I dunno, everything I know tells me to stimulate someone who Vagals. Just leaving them be and stepping over them runs contrary to all instincts. What if he passes out in an unsafe place? What if he injures himself on the way down? Obviously you can't stand there and do nothing if it happens. Maybe Mom will allow you to speak with the Dr. for clarification?

hrtprncss · Sep 7, 2005

I think what they're trying to say is to not get this guy up because if a patient has a hypervagal response and he's bradycardic and hypotensive, and is quite alert but symptomatic, getting them up technically would lead to a more severe reaction possibly causing orthostatic hypotension that can lead to loss of consciousness, of course when that happens you assess the guy and make sure that he's breathing well and if he is you put him on a side lying position and you wait until the medics come. i think that's what they mean when they said getting them up.

Jolie, BSN · Sep 7, 2005

Hi everyone,
I am new to this site, so "hello". I have a question. I can kind of figure this out, but cannot relate to the dehydation issue and to leave the child lay on the floor til he comes to...or he could die. I have a student who has this hypervagal response, and was told if he over exerts himself in physical exercise(mind you, he is overweight),he goes unconscious. So, he is told to drink lots of fluids before, during, and after exercise. This includes gatorade and some other mixture of potassium and oj. Mom says, "if he passes out, you are to leave him be til he awakens. Do not get him up". Well, as nurses we know if someone is down, you don't try to get them up, but you do try to arouse them to consciousness...or call 911. She says the Drs said he could die if you get him up right away. Can anyone explain this or has anyone ever heard of it? Just curious. I cannot find anything on this, other than the normal vagal response.
It sounds to me like there is more going on here than simply a "hypervagal" response. Why the extra dose of K+? It's not going to help relieve a vagal response. I think you need more information to formulate an appropriate plan of care for this student, which would include medication administration, guidelines for physical activity, and an emergency plan for managing fainting episodes. I would request a meeting with the parents, student, physician, classroom teacher and PE instructor. Good luck.

Thunderwolf, MSN, RN · Sep 7, 2005

I think you need more information to formulate an appropriate plan of care for this student, which would include medication administration, guidelines for physical activity, and an emergency plan for managing fainting episodes. I would request a meeting with the parents, student, physician, classroom teacher and PE instructor.

Good feedback. Everyone needs to be on the same page on this.

pongtipRN · Sep 14, 2008

One of my residents last night had what i assume to be a vasovagal response. He was being assisted to the bathroom via wheelchair, he is a COPD'er on 1.5 Liters of O2 via N/C. He is a 1 assist, he is able to maneuver himself from bed to wheelchair with assistance. Suddenly the aide noticed his feet were getting caught under the wheelchair, she asked him to pick up his feet, when he did not respond and she realized he was leaned forward in the chair. Called me (I am the only nurse to 60 residents on the night shift) and I came running, observed him slumped forward, cyanotic, with periods of apnea. Assisted him to bed (he was dead weight as he was unconscious), put HOB up to nearly 90 degrees. He was desatting at 71% at 1.5L, I increased his O2 to 5 Liters/min. He quickly increased to 98%, his V/S stable, 97.9 58 18 131/101. Fingerstick 146 mg/dL. He has a hx of CHF exacerbation, and thankfully a DNR. He regained consciousness and became alert and responsive to verbal stimuli within 5 minutes, his color was returning, and he was able to open his eyes and follow simple, 1-step commands within the next 5 minutes. O2 sat 99% on 5 L so i decreased to 3L which he did well at 97% where he remained until the next shift. Paged the doctor, and he didnt bother to call, so since the resident was stable and being monitored, left him comfortable in the bed until the day shift came in. Whew!