PODCAST: Syncope – An Interview With Dr. James Morris

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Syncope- An Interview With Dr. James Morris

See the EB Medicine Article @ https://www.ebmedicine.net/topics/cardiovascular/syncope

Why syncope? Prevalence, hospitalizations, etc.

Etiology: figure 1 is fantastic. Physiologic basis of syncope

Neurally mediated

Orthostatic – are we still doing orthostatic vitals in the ED?

Cardiac

Differentiating syncope from seizure

Features that point to seizure

Urinary incontinence

Number of jerks

Age?

Prehospital care is all about details

What did bystanders see?

What do paramedics see?

Any trauma?

Any neuro deficits ?

Glucose

ECG

ED  History – table 4

History of similar

Prodrome

Associated symptoms (chest pain, neuro symptoms, etc)

Falls

Pre-syncope ?

ED exam

Vitals, vitals, vitals

Orthostatic vitals ?

Carotid sinus massage, why this? Do we do in the ED?

ECG

Brugada, blocks, VT, ST changes, etc

Labs

BNP, delta bnp ?

Trop

Lactic acid

Pregnancy test

CBC

lutes

Bun/Cr

Echo – any role in the ED?

CT

Head

PE- get this on everyone ? Is it high prevalence?

Risk stratification tools- the bad and the worse

Table 7, amazing

Controversies

Admitting the elderly

Orthostatic vitals (we discussed already)

Disposition

 

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