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Emergency Department Management of Syncope

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Episode 58

Date: 06/01/2021 | Length: 51:46

Show Notes

Announcements:

  1. The Clinical Decision Making in the Emergency Department conference is June 23-27 live and virtual.
  2. Be on the lookout for an announcement regarding the new EB Medicine app, coming to an App Store near you this summer.

Why syncope? Prevalence, hospitalizations, etc.

Etiology: Physiologic basis of syncope

  1. Neurally mediated
  2. Orthostatic - are we still doing orthostatic vitals in the ED?
  3. Cardiac 

Differentiating syncope from seizure

  1. Features that point to seizure
  2. Urinary incontinence
  3. Number of jerks
  4. Age?

Prehospital care is all about details

  1. What did bystanders see?
  2. What do paramedics see?
  3. Any trauma?
  4. Any neuro deficits ?
  5. Glucose 
  6. ECG

ED History - Table 4

  1. History of similar
  2. Prodrome
  3. Associated symptoms (chest pain, neuro symptoms, etc)
  4. Falls
  5. Pre-syncope ?

ED exam

  1. Vitals, vitals, vitals
  2. Orthostatic vitals ?
  3. Carotid sinus massage, why this? Do we do in the ED?

ECG

  1. Brugada, blocks, VT, ST changes, etc

Labs

  1. BNP, delta bnp ?
  2. Trop
  3. Lactic acid
  4. Pregnancy test
  5. CBC
  6. lutes
  7. Bun/Cr

Echo - any role in the ED?

CT

  1. Head
  2. PE - Get this on everyone ? Is it high prevalence?

Risk stratification tools- the bad and the worse

Table 7

Controversies

  1. Admitting the elderly 
  2. Orthostatic vitals (we discussed already)

Disposition 

Have questions or comments on the podcast? Write us at emplify@ebmedicine.net

 

Meet the Host

Sam Ashoo, MD, FACEP

Dr. Ashoo is a practicing emergency physician, board-certified in emergency medicine and clinical informatics. Join him as he takes you through the June 2021 issue of Emergency Medicine Practice: Emergency Department Management of Syncope


About The Podcast

Get quick-hit summaries of hot topics in emergency medicine. EMplify summarizes evidence-based reviews in a monthly podcast. Highlights of the latest research published in EB Medicine's peer-reviewed journals educate and arm you for life in the ED.

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Publication Information
Author

James Morris, MD, MPH, FACEP

Peer Reviewed By

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

Publication Date

June 1, 2021

CME Expiration Date

June 1, 2024    CME Information

CME Credits

4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits.

Pub Med ID: 34008935

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Publication Information
Author

James Morris, MD, MPH, FACEP

Peer Reviewed By

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

Publication Date

June 1, 2021

CME Expiration Date

June 1, 2024

CME Credits

4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits.

Pub Med ID: 34008935

Get Permission

CME Information

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