Massage & Bodywork

January | February 2014

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• Has just had some hydrotherapy application involving heat (a hot whirlpool or a sauna, for example). 4. Pregnancy: Pregnant women are also predisposed to these incidents. Pregnancy involves significant shifts in levels of various hormones, some of which are involved in blood pressure regulation. The changes in hormone levels, combined with the increasing load the growing fetus places on the cardiovascular system, makes this population particularly vulnerable to these negative side effects. 5. Medications: Some medications— and not just blood pressure pills—may interfere with normal blood pressure regulation and may predispose someone to an episode of lightheadedness. Without knowledge of pharmacology, however, it's difficult to screen for these. WHAT TO DO IF A CLIENT FAINTS Just before fainting, a person may: • Feel a sense of anxiety. • Feel dizzy or lightheaded. • Feel nauseated. • Feel weak. • Have the sense that surrounding noises are fading into the background. • See spots before his or her eyes. The person knows that something is not quite right, but unless they've experienced it, they may not know that they are about to pass out. And they are often too embarrassed, or too confused, to say anything, which means they often faint without warning. The most common indicator that a client is not feeling well is if she is squirming in the chair. If you see her moving around, and the reason is not immediately evident, stop and ask specifically if she feels lightheaded or nauseous. You may see her skin turn pale, even on the back of her neck, but often this happens only as the person passes out. The experience can be frightening if you've never seen it before. The person's eyes will roll back into her head and you'll hear a very distinct breath sound. The client may start to stiffen up and maybe even convulse. Sometimes the convulsions are like a light tremor or shake, and sometimes it may appear as though the person is having a mild epileptic episode. It's important to note that fainting itself is not harmful. It is simply nature's way of making you stop what you're doing and putting you on the ground until your blood pressure normalizes. The therapist's primary concern is making sure that the client does not fall and hurt herself in the process. Being on the floor is the safest position for the client until she recovers. If someone reports feeling nauseous or dizzy, don't leave her in the chair while you fetch a glass of water or a cold compress. Get her on the floor first. Rather than being angry or upset after they recover, most people are simply embarrassed, so be as discreet as possible in handling the situation. Don't make a big deal out of the incident; reassure the people around you that your client has just fainted. Let them know this happens occasionally and that there is no need for alarm or to call emergency medical services (of course, unless the client insists). In a busy massage practice, it's not unlikely that you will sometimes have a client faint. Fortunately, you can largely prevent these fainting episodes by simply paying close attention to the way you set your client up in the chair and being in tune with the client's body language. If someone does faint, following the simple guidelines outlined here will help prevent injuries, keep your client safe, and make sure everybody walks away unfazed. Notes 1. J. E., "Hyperactive Carotid Sinus Reflex and Carotid Sinus Syncope," Mayo Clinic Proceedings 44, no. 2 (February 1969): 127–39. 2. W. J. Kleemann et al., "Kann ein Griff an den Hals zum reflektorischen Herztod führen?" [Can pressure applied to the neck cause a reflex leading to cardiac death?], in Ersticken: Fortschritte in der Beweisführung (Springer, 1990), B. Brinkmann, K. Püschel (eds.). 3. H. Franke, "On the Hyperactive Carotid Sinus Syndrome," Acta Neuroveg 25 (1963): 187–203. Eric Brown is a frequent Massage & Bodywork contributor. Learn more about him and his work at www.bodyworkbiz.com. It pays to be ABMP Certified: www.abmp.com/go/certifiedcentral 67

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