Why could two soldiers lose consciousness in the same circumstances? What exactly happens in the body during vagal discomfort? And above all, how to recognize the warning signs to avoid falling? Dr. Gérald Kierzek, emergency physician and medical director of True Medical, helps us understand.
Two guards collapse within seconds of each other in front of the Élysée
The scene surprised even those present on the presidential steps. Wednesday November 11, while Emmanuel Macron was preparing to welcome Peter Pellegrini, President of Slovakia, two members of the Republican Guard fell victim to illness in front of the Élysée Palace.
The images in the sequence show the first soldier gradually losing his balance. His sabre, which he holds at arm’s length as part of protocol, wavers before escaping him. The guard then collapses against a pillar, before the eyes of the head of state. Emmanuel Macron and several people present rushed to him to help him.
A few moments later, a second soldier in turn suffered from illness, outside the camera’s field of view. The sound of his saber falling to the ground alerts those present.
The scene, particularly unusual in such a solemn context, quickly circulated on social networks.
But the concern gave way to relief when the Élysée communicated on the state of health of the two men. “They each had vagal discomfort and were treated immediately. They have no injuries and are doing well.”indicated the entourage of the President of the Republic, Thursday November 12, according to The Parisian and The
HuffPost.
Behind these impressive images, a relatively common medical phenomenon could therefore explain the two losses of consciousness. And the circumstances of the ceremony are probably not unrelated to what happened.
Standing, stress, fatigue: why can the body suddenly give up?
How can we explain that two soldiers, a priori in full possession of their means, lose consciousness almost simultaneously? Dr Gérald Kierzek puts forward several factors likely to explain these two episodes.
“Standing still for a prolonged period, combined with the stress and pressure of an official ceremony, can promote vagal discomfort. Certain periods, particularly those marked by gastrointestinal infections, can also increase the risk.explains the emergency doctor.
In the case of the Republican Guards, prolonged standing constitutes a particularly interesting avenue. When a person remains still for a long time, blood may tend to pool in the lower extremities. The return of blood to the heart then decreases, which can lead to a drop in blood pressure.
The stress and pressure associated with an official ceremony can also contribute to triggering discomfort. Heat under the uniform, fatigue or dehydration are other contributing factors.
A digestive infection can also weaken the body: in the event of vomiting or diarrhea, the loss of water and mineral salts can notably promote a drop in blood pressure and increase the risk of feeling unwell.
But what exactly is happening in the body?
Vagal discomfort, also called vasovagal syncope when it causes loss of consciousness, corresponds to an excessive reaction of the autonomic nervous system. This regulates heart rate and blood pressure without us having to think about it.
When a vagal reflex is triggered, the heart slows down and blood vessels may dilate. Blood pressure then drops, temporarily reducing blood supply to the brain. Result: the person may lose consciousness.
Dr. Kierzek recalls that this type of episode is generally characterized by a loss of consciousness preceded by warning signs, called prodromes, then by a relatively rapid return to consciousness.
These warning symptoms can take several forms: sudden feeling of heat, cold sweats, nausea, dizziness, blurred vision, ringing in the ears or feeling of weakness in the legs. Spotting them is essential: they can allow you to lie down before losing consciousness and thus avoid a fall.
In the majority of cases, the person regains consciousness quickly once lying down, because this position facilitates the return of blood to the brain. According to Health Insurance, syncope corresponds to a complete and brief loss of consciousness, generally lasting a few seconds to less than three minutes.
How to avoid vagal discomfort and what to do when it occurs?
Although vagal discomfort is generally benign, it can be impressive for the person experiencing it and for those around them. However, certain precautions can limit the risk, particularly in people who are prone to it.
The first is to avoid standing still for too long. When possible, it is better to walk for a few moments, mobilize your legs regularly or contract the muscles of your calves and thighs. These movements promote the return of blood to the heart.
Hydration also plays an important role. Drinking enough, especially in hot weather or during illness, helps maintain adequate blood volume. Fatigue, lack of sleep and episodes of gastroenteritis also deserve special attention.
But what to do when the first signs appear? The good reflex is to lie down immediately, ideally by raising your legs, to facilitate blood flow to the brain. If lying down is impossible, sitting down quickly can already limit the risk of falling and injury. Certain maneuvers, such as crossing the legs associated with muscle contraction, can also help prevent loss of consciousness.
For a person who loses consciousness, check that they are breathing normally and place them in a safety position if they remain unconscious while breathing. If there is no normal breathing, call 15 or 112 and start cardiopulmonary resuscitation.
Finally, a loss of consciousness should never be automatically attributed to vagal discomfort. A first episode, repeated discomfort, chest pain, palpitations, shortness of breath or occurring during exercise require rapid medical evaluation. A loss of consciousness that does not resolve quickly is also a warning sign.
Because if vagal discomfort is often without consequence, the main thing is not to trivialize a loss of consciousness. Behind an apparently spectacular episode, like that experienced by the two Republican Guards, there is sometimes a temporary physiological reaction. It is still necessary to ensure that no other cause is hidden behind it.