Contributor: Don Stader, MD

Educational Pearls:

• Syncope is usually benign but can be caused by serious etiologies which include: PE, certain cardiac arrhythmias, AAA, intracranial bleed/stroke
• The Canadian Syncope Rule appears to identify those patients with syncope and low risk of serious outcomes
• The score is based on vital signs, EKG and history
• Negative scores preclude a very low risk of adverse events
• A calculated score greater than 1 are considered medium risk
• Scores greater than 4 are high risk
• Anyone with a medium risk or higher should have their cause thoroughly investigated - which may involve admission or a shared decision making utilizing this rule if discharged

Editor's note: just remember this rule has not been externally validated… yet

References

https://www.mdcalc.com/canadian-syncope-risk-score

Thiruganasambandamoorthy V, Kwong K, Wells GA, et al. Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope. CMAJ. 2016;188(12):E289–E298. doi:10.1503/cmaj.151469

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD