If someone near you has passed out, don’t try to shake them awake or splash water on their face. The safest approach is to check whether they’re breathing, position their body to protect them, and let blood flow back to their brain naturally. Most fainting episodes resolve on their own within seconds to a minute. Your job is to keep the person safe until they come around, and to call 911 if they don’t.
Check for Breathing First
Before anything else, make sure the area around the person is safe for both of you. Look for hazards like traffic, broken glass, or nearby ledges. Then tap their shoulder firmly and ask loudly, “Are you OK?” If they don’t respond, check whether their chest is rising and falling. Lean close to listen for breath sounds and feel for air against your cheek.
If the person is breathing, you have time to help them. If they are not breathing and not responding, call 911 immediately and begin CPR if you’re trained. The American Heart Association recommends starting with 30 chest compressions before opening the airway. Someone who isn’t breathing is in a different category of emergency than someone who fainted, and every second matters.
Raise Their Legs Above Heart Level
For a person who fainted but is still breathing, the single most effective thing you can do is lay them flat on their back and elevate their legs about 12 inches (30 centimeters), propping them on a bag, a chair, or your own knees. This helps blood flow back toward the brain, which is almost always what caused the fainting in the first place. Most syncope (the medical term for fainting) happens because the brain briefly lost adequate blood supply.
Loosen any tight clothing around the neck, chest, or waist. Belts, ties, and buttoned collars can restrict circulation and breathing. Keep the person lying down even after they start to stir. Getting up too quickly can trigger a second fainting episode.
Why You Should Never Shake Them
The instinct to grab someone by the shoulders and shake them is strong, but it’s genuinely dangerous. A case report published in the forensic medicine literature documented two adults who were vigorously shaken by people trying to wake them. Both suffered bilateral brain hemorrhages. One was declared brain dead. The mechanism is the same one that causes shaken baby syndrome: the brain moves inside the skull, tearing small blood vessels.
You also can’t know whether the person injured their neck or spine when they fell. Shaking, moving their head, or pulling them upright could worsen a spinal injury that you can’t see. A firm shoulder tap and a loud voice are enough stimulation. If that doesn’t work, the person needs medical help, not more force.
Skip the Smelling Salts
Ammonia inhalants (smelling salts) are sometimes portrayed as a quick fix, but sports medicine guidelines actually advise against them. Smelling salts trigger a sharp withdrawal reaction, causing the person to jerk their head away. If there’s any possibility of a neck injury from the fall, that sudden head movement can make things worse. More importantly, using smelling salts can create a false sense that the person is fine, delaying the medical evaluation they may actually need.
Use the Recovery Position if Needed
If the person is breathing but doesn’t wake up within a minute, or if you’re concerned they could vomit, roll them into the recovery position to keep their airway clear. Here’s how:
- Start with them on their back. Kneel beside them.
- Position the near arm. Extend the arm closest to you straight out at a right angle, palm facing up.
- Fold the far arm. Bring their other hand across and rest the back of it against the cheek nearest to you. Hold it there.
- Bend the far knee. With your free hand, pull up their far knee to a right angle.
- Roll them toward you. Pull gently on the bent knee so they roll onto their side. Their folded arm supports their head, and the bent leg stops them from rolling face-down.
- Open the airway. Tilt the head back gently and lift the chin to make sure nothing is blocking their breathing.
Stay with them and keep monitoring their breathing until help arrives or they wake up.
When to Call 911
Call emergency services if the person doesn’t regain consciousness within one minute. That’s the threshold recommended by the American College of Emergency Physicians. Also call if you notice any of these:
- Seizure-like movements lasting more than a few seconds
- Signs of a stroke (facial drooping, slurred speech, arm weakness)
- Chest pain or difficulty breathing before or after the episode
- A head injury from the fall
- The person is pregnant, elderly, or has a known heart condition
Brief muscle twitches during a faint can look alarming, but they’re common and don’t necessarily mean the person is having a seizure. In fainting, these jerks typically last only seconds and stop once blood flow returns to the brain. A seizure usually involves rhythmic movements lasting minutes, with a longer period of confusion afterward. If you’re unsure which you’re seeing, call 911.
Fainting vs. Something More Serious
Simple fainting is usually a quick event. The person loses consciousness for seconds, not minutes, and recovers fully once they’re lying down. Common triggers include standing too long, dehydration, heat, sudden pain, or an intense emotional reaction. These episodes are alarming to witness but are rarely dangerous on their own.
Cardiac-related fainting is a different story. If the person felt palpitations, chest pain, or shortness of breath before they went down, or if the episode happened during exercise, the cause may be an abnormal heart rhythm. Fainting that happens more than once in a month, or that comes with confusion, blurred vision, or trouble speaking afterward, also warrants a medical evaluation even if the person seems fine in the moment.
After They Wake Up
Once the person regains consciousness, don’t let them jump to their feet. Have them stay lying down for another one to two minutes, then sit up slowly and remain seated for another minute or two before standing. This gradual transition prevents the blood pressure drop that could cause them to faint again.
Offer water or a sports drink, especially if they’ve been in heat, exercising, or haven’t eaten recently. A cool, quiet place to sit is ideal. Watch them closely for the next 15 to 20 minutes. If they feel increasingly dizzy, develop a headache, seem confused, or faint a second time, that’s a sign something beyond a simple faint is going on and they need medical attention.