Which protocol should be used for a patient with ground-level falls from fainting or dizziness?

• A. Protocol 31
• B. Protocol 21
• C. Protocol 26
• D. Protocol 32

Answer: (A)

Fainting with a fall points to possible syncope complicated by trauma, so the protocol that covers fainting with a fall is the one to use. This choice is the best because it directs you to explore the sequence of events leading to the loss of consciousness, look for red flags that suggest a serious underlying cause (such as cardiac symptoms, stroke, head injury, or dehydration), and manage both the potential injury from the fall and the ongoing risk while awaiting help. It emphasizes assessing airway, breathing, and circulation, monitoring mental status, and identifying warning signs that require immediate EMS transport (for example chest pain, trouble breathing, severe headache, weakness or numbness, confusion, or persistent vomiting). It also guides you to obtain information about meds, prior episodes, and any preceding dizziness or palpitations to distinguish syncope from other causes of dizziness. Other protocols handle different presentations, such as dizziness without a collapse or isolated trauma without syncope, which don’t address the dual concerns of a fainting episode followed by a fall.