Syncope
Posted: January 18, 2012 Filed under: Podcasts 3 Comments »Syncope (or “passing out”) is a chief complaint that we deal with a lot in the emergency department. While most causes of syncope are benign and need nothing more than reassurance, we need to be on the lookout for the serious causes of syncope. This episode will focus on the definition of syncope, how to get a complete history, catch the red flags, perform a targeted workup that doesn’t keep the patient in the ED forever, and how to scrutinize an EKG for the deadly arrhythmias that we can’t miss.
In addition, per a request from a podcast listener, there is a bonus section on how to effectively rehydrate patients in the ED. You may be surprised that there are other options besides putting an IV in everyone
Syncope show notes (Word format)
Syncope show notes (PDF format)
[...] spot this week Steve provied a nuts and bolts simplified approach to the patient presenting with syncope. He covers what tests need doing, all the way through to who needs to stay for further work-up and [...]
Steve,
Great work, what was your source for the Head CT and Trop only being 0.5% sens? Was it: Mendu et. al, Arch Intern Med. 2009
http://archinte.ama-assn.org/cgi/content/abstract/169/14/1299
Thanks,Chris
Chris
I got that figure from Amal Mattu’s podcast- EMcast. That is probably the right citation- I will see if he cited it in his show notes and get back to you. I briefly looked at the study and it appears to line up with the 0.5% figure. There were a higher percentage of people with positive tests but few of them made a difference in management (that’s the 0.5% figure). You can have that mildly positive troponin that doesn’t trend upwards and doesn’t make a difference in your management.
Thanks for listening and thanks for commenting- its good to be looking at these citations and I’ll try to post the important citations in the show notes. I haven’t been doing it a lot because I don’t want people to get too bogged down and this isn’t meant to be a literature review blog/podcast like others out there. That being said- I should have posted that one- thanks for looking it up!
Steve
FYI- If you saw the previous version of the comment- I misread your email address- I thought you were someone from my residency commenting- thus the comment about being chief