Syncope in the Emergency Department
Syncope is a common presentation to Emergency Departments (EDs). Estimates on the frequency of visits (0.6–1.7%) and subsequent rates of hospitalizations (12–85%) vary according to country. The initial ED evaluation for syncope consists of a detailed history, physical examination and 12-lead electro...
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doaj-c468ab35d63048c2ad14446133a9954b2020-11-24T22:09:10ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2019-12-01610.3389/fcvm.2019.00180497130Syncope in the Emergency DepartmentRoopinder K. Sandhu0Robert S. Sheldon1Division of Cardiology, University of Alberta, Edmonton, AB, CanadaDepartment of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, CanadaSyncope is a common presentation to Emergency Departments (EDs). Estimates on the frequency of visits (0.6–1.7%) and subsequent rates of hospitalizations (12–85%) vary according to country. The initial ED evaluation for syncope consists of a detailed history, physical examination and 12-lead electrocardiogram (ECG). The use of additional diagnostic testing and specialist evaluation should be based on this initial evaluation rather than an unstructured approach of broad-based testing. Risk stratification performed in the ED is important for estimating prognosis, triage decisions and to establish urgency of any further work-up. The primary approach to risk stratification focuses on identifying high- and low-risk predictors. The use of prediction tools may be used to aid in physician decision-making; however, they have not performed better than the clinical judgment of emergency room physicians. Following risk stratification, decision for hospitalization should be based on the seriousness of the underlying cause for syncope or based on high-risk features, or the severity of co-morbidities. For those deemed intermediate risk, access to specialist assessment and related testing may occur in a syncope unit in the emergency department, as an outpatient, or in a less formal care pathway and is highly dependent on the local healthcare system. For syncope patients presenting to the ED, ~0.8% die and 10.3% suffer a non-fatal severe outcome within 30 days.https://www.frontiersin.org/article/10.3389/fcvm.2019.00180/fullsyncopeemergency department (ED)initial evaluationrisk stratificationoutcomes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Roopinder K. Sandhu Robert S. Sheldon |
spellingShingle |
Roopinder K. Sandhu Robert S. Sheldon Syncope in the Emergency Department Frontiers in Cardiovascular Medicine syncope emergency department (ED) initial evaluation risk stratification outcomes |
author_facet |
Roopinder K. Sandhu Robert S. Sheldon |
author_sort |
Roopinder K. Sandhu |
title |
Syncope in the Emergency Department |
title_short |
Syncope in the Emergency Department |
title_full |
Syncope in the Emergency Department |
title_fullStr |
Syncope in the Emergency Department |
title_full_unstemmed |
Syncope in the Emergency Department |
title_sort |
syncope in the emergency department |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Cardiovascular Medicine |
issn |
2297-055X |
publishDate |
2019-12-01 |
description |
Syncope is a common presentation to Emergency Departments (EDs). Estimates on the frequency of visits (0.6–1.7%) and subsequent rates of hospitalizations (12–85%) vary according to country. The initial ED evaluation for syncope consists of a detailed history, physical examination and 12-lead electrocardiogram (ECG). The use of additional diagnostic testing and specialist evaluation should be based on this initial evaluation rather than an unstructured approach of broad-based testing. Risk stratification performed in the ED is important for estimating prognosis, triage decisions and to establish urgency of any further work-up. The primary approach to risk stratification focuses on identifying high- and low-risk predictors. The use of prediction tools may be used to aid in physician decision-making; however, they have not performed better than the clinical judgment of emergency room physicians. Following risk stratification, decision for hospitalization should be based on the seriousness of the underlying cause for syncope or based on high-risk features, or the severity of co-morbidities. For those deemed intermediate risk, access to specialist assessment and related testing may occur in a syncope unit in the emergency department, as an outpatient, or in a less formal care pathway and is highly dependent on the local healthcare system. For syncope patients presenting to the ED, ~0.8% die and 10.3% suffer a non-fatal severe outcome within 30 days. |
topic |
syncope emergency department (ED) initial evaluation risk stratification outcomes |
url |
https://www.frontiersin.org/article/10.3389/fcvm.2019.00180/full |
work_keys_str_mv |
AT roopinderksandhu syncopeintheemergencydepartment AT robertssheldon syncopeintheemergencydepartment |
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