Episode 58 - Syncope - An Interview With Dr. James Morris

EMplify - June 2021

Announcements:

* The Clinical Decision Making in the Emergency Department conference is June 23-27 live and virtual. More information here: https://clinicaldecisionmaking.com

* Be on the lookout for an announcement regarding the new EB Medicine app, coming to an App Store near you this summer !!

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