The management depends on the underlying cause, which could range from a benign cause (such as dehydration or a vasovagal episode) to a life-threatening emergency (such as cardiac arrest, stroke, or severe hypoglycemia).
Check Responsiveness: Shake the patient gently and ask, "Are you okay?"
Check Pulse & Breathing: If no pulse or breathing, initiate CPR immediately and Call for help. Have an assistant phone 911 or code blue if in a hospital).
If Breathing & Pulse Present: Position the patient on their back, elevate legs if hypotensive.
If Unconscious but Breathing: Place in the recovery position to prevent aspiration.
If Hypoglycemia Suspected (history of diabetes, cold/clammy, altered mental status): Give oral glucose if alert; administer IV dextrose 50% if unconscious.
If Hypotension (shock, dehydration, sepsis, or bleeding suspected): Start IV fluids (e.g., normal saline or lactated Ringer’s).
If Stroke Suspected (FAST criteria—Facial droop, Arm weakness, Speech difficulty): Activate stroke protocol and get an urgent CT scan.
If Suspected Cardiac Event (chest pain, arrhythmia): Obtain ECG, cardiac enzymes, and initiate ACLS protocol if needed.
Common causes of collapse in elderly patients include:
Cardiac: Arrhythmias (AF, bradycardia, VT/VF), MI, aortic stenosis
Neurological: Stroke, seizure, syncope, TIA
Metabolic: Hypoglycemia, electrolyte imbalances, dehydration
Vasovagal or Orthostatic Hypotension: Sudden BP drop from standing
Infections: Sepsis, pneumonia, UTI
Medications: Polypharmacy, overuse of antihypertensives, sedatives
Continuous monitoring (ECG, oxygen saturation, BP)
Transfer to ER or ICU based on severity
Perform further workup: Blood tests (CBC, BMP, troponins, ABG, cultures), imaging (CT head, CXR, echocardiogram, Doppler US if DVT suspected)