I took a shift tonight. Expecting it to be a quiet night, I settled in to relax and enjoy the concert. As one of the starting bands started their show, we got dispatched to “a child crying”.
I lead our way up through the dark tunnel as a host motioned us to one of the seats. The child’s dad told me his child had hit his funny bone, felt pain in his head and then fainted and was unresponsive for a while. I looked at a child who appeared to be 7 years old. He was now awake and on inspection doesn’t appear to be hurt anywhere.
We moved out to an administration booth nearby since it was quieter. I did a set of vitals, asked the child a bunch of questions and unsurprisingly he was stable and said he wasn’t hurting anywhere. Then the mother shows up. She was really worried saying that their family has a history of brain aneurysms. Then as if on cue, the child says that the right side of his temple hurts, just a little bit. My partner and I glanced at each other thinking great. However, the child wasn’t showing any signs and symptoms of a brain aneurysm. I turned to the agitated parents.
Me: I checked your child’s eyes, his heart rate, his breathing…his vitals are good and he’s alert and coherent. Those are really good signs.
Hmmm that didn’t seem to reassure the parents.
Me: There really isn’t much we can do for your son right now, but if you want we can go to the first aid room and monitor him for a little bit and take a blood pressure.
That seemed to do the trick in reassuring the parents and placing them more at ease. I also wanted to take a BP just in case. At this point I’m thinking that hitting the funny bone somehow triggered the child to faint…like seeing blood. However I couldn’t be sure. Do people really faint from hitting their funny bone? I had no idea.
When we got to the first aid room I sat the child on a chair and to place him at ease, we tried to find a cartoon channel that he’d like on the tv. Then I asked my partner to radio in for someone downstairs to bring us a pediatric BP cuff.
Me: Have you ever had your blood pressure taken before?
Child: No…does it hurt?
He sounded nervous.
Me: Nope! Not at all.
At this point I remembered what I learned in my Exercise Prescription class in university for exercise testing with children:
Let the child play and get to know the equipment before starting, and if possible, turn it into a game.
I guess I have to opt out on the game option, since we can’t really be playing who can pump up the blood pressure cuff the fastest before the other person screams, or who could have a BP cuff on the longest before losing an arm.
Me: Here, this is how it works.
I wrapped the adult BP cuff around my arm. He looked at me curiously.
Me: See this pump? Squeeze it, it’ll inflate this cuff like a balloon.
He started squeezing and watched as the cuff inflates. The mother looked on amused with my interaction with her child.
Me: Okay now you turn that silver knob and all the air will woosh out.
He turned the knob and a big hissing sound escaped. He smiled.
Me: Are you ready for me to take your blood pressure?
His blood pressure was normal. His head now no longer hurts. After reassuring the thankful parents one more time, I told them they can go enjoy the concert and if anything happens they can give us a call.
When I got home I looked up the common triggers that can cause a vasovagal syncope (stimulation of the vagal nerve resulting in fainting from your body diverting blood away from your head to another part of the body; also causes your heart to slow down). I knew the two most well-known and common trigger for vasovagal syncope: Sight of blood and bowel movement.
I skimmed down the list and there it was! “Hitting the funny bone” was on the common triggers list! Well that explains it all. Who would have ever guessed? I sure didn’t.
Learn something new everyday.
Next time you get called to someone who hits their elbow and faints. Vasovagal syncope could well possibly be the reason 😉