Urgent Care Approach to the Syncopal Patient | Points and Pearls
0

Urgent Care Approach to the Syncopal Patient

Below is a free preview. Log in or subscribe for full access. Or get a sample issue of Evidence-Based Urgent Care:
Please provide a valid email address.

*NEW* Quick Search this issue!

Points and Pearls Excerpt

  • Syncope is a transient loss of consciousness, typically with associated loss of postural tone, followed by complete, spontaneous recovery.
  • Syncope results from global cerebral hypoperfusion from decreased peripheral vascular resistance, decreased cardiac output, or both.
  • There are 3 classifications of syncope: (1) neurally mediated (reflex) syncope (the most common): (2) orthostatic hypotension (second most common), and (3) cardiac syncope (the least common, but with highest morbidity). (See Table 1.)
To Read The Companion Article:
To Read The Companion Article:
To Read The Companion Article:
Publication Information
Editor in Chief & Update Author

Keith Pochick, MD
Novant GoHealth Urgent Care

Urgent Care Peer Reviewer

Joseph Toscano, MD
John Muir Urgent Care; San Ramon Regional Medical Center

Charting Commentator

Patrick O’Malley, MD
Newberry County Memorial Hospital

Author

James Morris, MD, MPH, FACEP

Peer Reviewed By

Deborah Diercks, MD, MS, FACEP, FACC; Marc A. Probst, MD, MS, FACEP

Publication Date

April 1, 2022

CME Expiration Date

April 1, 2025    CME Information

CME Credits

4 AMA PRA Category 1 Credits™. 4 AOA Category 2-A or 2-B Credits.

Get Permission

Charting Tips

Syncope can be the result of causes ranging from benign to life threatening. A detailed history and physical examination, along with an ECG, are among the most important aspects of the workup for a postsyncopal patient, and must be documented.

History

  • Activity before and after the event, exertional activity, prodromal symptoms
  • Duration of event and time to return to baseline
  • Past medical history of coronary artery disease, pacemaker, defibrillator, or dysrhythmia
  • Previous episodes
  • Previous workup
  • Input from bystander/family

Physical Examination

  • Address any abnormal vital signs, especially persistent bradycardia and tachycardia
  • New or undiagnosed murmur
  • Abdominal tenderness, rectal exam, color of conjunctiva

Electrocardiogram

  • Look for ischemic changes
  • Mobitz II second- and third-degree atrioventricular block
  • Intraventricular conduction delays
  • Compare to previous ECGs if possible
Content you might be interested in
Already purchased this course?
Log in to read.
Purchase a subscription

Price: $449/year

140+ Credits!

Purchase Issue & CME Test

Price: $59

+4 Credits!

Money-back Guarantee
Get A Sample Issue Of Emergency Medicine Practice
Enter your email to get your copy today! Plus receive updates on EB Medicine every month.
Please provide a valid email address.