Emergency Response for Seizures and Fainting: An Insider's Guide to Navigating Medical Care in Cuenca

As a medical system navigator and patient advocate here in Cuenca, I've stood beside expats during their most vulnerable moments. I've translated for them in the emergency room, navigated insurance paperwork, and helped them understand a foreign system in a moment of crisis. The beauty of Cuenca is one thing; feeling safe and prepared for a health emergency is another.

One of the most frightening events is witnessing a seizure or a sudden loss of consciousness (fainting). My goal with this guide is to move beyond generic advice and give you the specific, on-the-ground knowledge you need to act confidently, eliminate confusion, and ensure you or your loved one receives excellent, timely care.

First, Distinguish the Event: Fainting vs. Seizure

While both are alarming, they have different causes and require slightly different immediate responses.

• Fainting (Syncope): This is a brief loss of consciousness caused by a temporary drop in blood flow to the brain. Think dehydration, low blood sugar, or standing up too quickly in Cuenca’s high altitude. Recovery is usually swift, though the person may feel weak or dizzy.
• Seizures: This is a neurological event caused by abnormal electrical surges in the brain. Manifestations range from a blank stare to full-body convulsions (a tonic-clonic seizure). The period after a seizure, known as the postictal state, often involves deep confusion, exhaustion, or headache.

Immediate Safety Protocols: Your First 60 Seconds are Crucial

When someone collapses, your calm and correct actions can prevent serious injury.

If Someone Faints:

1. Prevent a Hard Fall: Guide them gently to the floor.
2. Elevate the Legs: Place them on their back and prop their feet up on a backpack, purse, or folded jacket, about 12 inches above their heart. This simple action uses gravity to help restore blood flow to the brain.
3. Loosen Constricting Clothing: Unbutton collars or loosen scarves.
4. Monitor Breathing: Ensure their airway is clear and they are breathing.
5. Wait for Recovery: Consciousness should return within a minute. Encourage them to stay down for at least 5-10 minutes before slowly sitting up to prevent a recurrence. Do not give them anything to eat or drink until they are fully alert.
6. Seek Medical Attention If: They don't regain consciousness quickly, injured themselves in the fall, have a known heart condition, or if this is a first-time event.

If Someone is Having a Seizure:

Your sole job is to keep them safe. You cannot stop a seizure once it has started.

1. Ease Them to the Floor: If you can, protect their head from hitting the ground.
2. Clear the Area: Quickly move furniture, sharp objects, or anything they could strike.
3. Cushion Their Head: Slide a jacket or something soft under their head.
4. Turn Them on Their Side (Recovery Position): As soon as the convulsions stop, or if there is any fluid/vomit in their mouth, gently roll them onto their side. This keeps their airway open and prevents choking.
5. Time the Seizure: Note the start and end time. This is one of the most critical pieces of information for the medical team.
6. Crucially, Do NOT:
   • Restrain them. This can cause fractures or dislocations.
   • Put anything in their mouth. This is a dangerous myth. You cannot swallow your tongue, and putting objects in the mouth can break teeth, fracture the jaw, or create a choking hazard.
7. Stay With Them: Reassure them calmly as they regain consciousness. They will be confused and disoriented.

Accessing Emergency Medical Help in Cuenca: The Expert Playbook

Knowing the right numbers is just the start. Knowing what to expect is key.

The Emergency Numbers:

• 911: This is now the universal emergency number in Ecuador, integrated into the ECU 911 system. It connects you to police, fire, and ambulance services. Operators are trained for emergencies, but you should expect to communicate in Spanish.
• Private Ambulance Services: If you have private insurance and a preferred hospital, calling their ambulance directly can be faster and ensures you are taken to your facility of choice.
  • Hospital del Río: (07) 413-3000 (Ask for Ambulancia)
  • Hospital Monte Sinai: (07) 288-5595 (Ask for Ambulancia)

What to Say to Emergency Dispatch (Even with Basic Spanish):

Be clear and concise. Write this down and keep it in your wallet.

1. Start with: “¡Emergencia! Necesito una ambulancia.” (Emergency! I need an ambulance.)
2. State the problem: “Hay una persona inconsciente.” (There is an unconscious person.) OR “Hay una persona con convulsiones.” (There is a person with convulsions.)
3. Give your exact location: Speak slowly. “Estoy en [Your Street Address], entre [Cross Street 1] y [Cross Street 2]. Edificio [Building Name], Apartamento [Number].” Provide clear landmarks.
4. Answer their questions as best you can. They will dispatch help immediately.

Choosing a Hospital: A Critical Insider's Distinction

For any serious neurological event, you will want to go to a private hospital. The two premier choices are Hospital del Río and Hospital Monte Sinai.

• Hospital del Río: Generally considered the top-tier facility for complex cases and emergencies. It has the most robust 24/7 specialist coverage (neurologists, cardiologists on call) and a highly streamlined process for accepting international insurance. This is often the best choice for a true, time-sensitive emergency where you may need immediate, specialized diagnostics.
• Hospital Monte Sinai: An excellent hospital with a renowned cardiology department and outstanding facilities. While they handle emergencies expertly, the administrative process for some international insurance plans can sometimes be less direct than at Del Río.

What to Expect at the ER: You'll go through triage immediately. Have your passport or cédula and insurance card ready. With common expat plans like IHI Bupa or BMI, expect an initial co-pay of $25 to $50 for the emergency consultation. You will be responsible for your deductible and any non-covered costs.

Communicating with Medical Staff: Bridging the Language Gap

In an emergency, clear communication is non-negotiable.

• Your Historia Clínica: The first thing the medical team will do is start your patient file, your historia clínica. Be prepared. Keep a note on your phone or a card in your wallet with:
  • Current medications and dosages
  • Known allergies
  • Major medical conditions (e.g., hipertensión, diabetes, epilepsia)
  • Your primary doctor’s contact info
• Finding an English Speaker: In the ER, politely but firmly ask, "¿Hay un doctor que hable inglés, por favor?" (Is there a doctor who speaks English, please?). At Del Río or Monte Sinai, they will almost always find someone.
• After Stabilization: The doctor will likely order diagnostic tests. You will receive a printed order (una orden médica) for blood work or imaging. Hyper-Specific Tip: Unlike in the U.S., you often take this order to the hospital's lab or imaging department, pay for the service upfront (cancelar en efectivo o con tarjeta), and then get the test done. Remember to ask if you need to be fasting (en ayunas) for blood tests.
• Post-Discharge Medication: If you need medication, you'll get a prescription. One of the most reliable and centrally located 24-hour pharmacies is the Fybeca on Avenida Remigio Crespo. It is well-stocked and staff are accustomed to prescriptions from the major hospitals.

⚠️ Health Warning: The Assumption That Can Have Devastating Consequences

From my direct experience as a patient advocate, the single most dangerous mistake an expat can make after a seizure or unexplained fainting episode is chalking it up to a one-time event and failing to get a full neurological workup.

I have seen cases where a "simple faint" was actually the first sign of a serious cardiac arrhythmia, or a "small seizure" was the initial presentation of a brain tumor. Dismissing these events because you feel fine afterward, or delaying evaluation because of fear or language barriers, is a gamble you cannot afford to take. The difference between a proactive diagnosis and a delayed one can be life-altering. Always, always get checked out by a qualified specialist.