SYNCOPE IN THE EMERGENCY DEPARTMENT: A GUIDE FOR CLINICIANS

被引:5
作者
El-Hussein, Mohamed Toufic [1 ,2 ,3 ]
Cuncannon, Alexander [1 ]
机构
[1] Mt Royal Univ, Fac Hlth Community & Educ, Sch Nursing & Midwifery, 4825 Mt Royal Gate SW, Calgary, AB T3E 6K6, Canada
[2] Univ Calgary, Fac Nursing, Calgary, AB, Canada
[3] Rockyview Gen Hosp, Med Cardiol Coronary Care Unit, Calgary, AB, Canada
关键词
Syncope; Emergency department; Shared decision-making; Risk stratification;
D O I
10.1016/j.jen.2020.11.002
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Syncope is a common presenting symptom to emergency departments, but its evaluation and initial management can be challenging for ED practitioners and particularly urgent in the presence of high-risk features that increase the likelihood of cardiac etiology. Even after thorough clinical evaluation, syncope may remain unexplained. In such instances, practitioners? clinical judgment and risk assessments are critical to guide further management. In this article, evidence-informed strategies are outlined to approach the diagnosis of syncope and provide an overview of syncope clinical decision rules and shared decision-making. By incorporating risk stratification and shared decision-making into syncope care, practitioners can more confidently engage patients and families in disposition decisions to organize appropriate outpatient and follow-up care, observation, or admission.
引用
收藏
页码:342 / 351
页数:10
相关论文
共 44 条
[31]   2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society [J].
Shen, Win-Kuang ;
Sheldon, Robert S. ;
Benditt, David G. ;
Cohen, Mitchell I. ;
Forman, Daniel E. ;
Goldberger, Zachary D. ;
Grubb, Blair P. ;
Hamdan, Mohamed H. ;
Krahn, Andrew D. ;
Link, Mark S. ;
Olshansky, Brian ;
Raj, Satish R. ;
Sandhu, Roopinder Kaur ;
Sorajja, Dan ;
Sun, Benjamin C. ;
Yancy, Clyde W. .
CIRCULATION, 2017, 136 (05) :E25-+
[32]   CLINICAL DECISION SUPPORT SYSTEMS IN THE EMERGENCY DEPARTMENT: OPPORTUNITIES TO IMPROVE TRIAGE ACCURACY [J].
Stone, Elizabeth L. .
JOURNAL OF EMERGENCY NURSING, 2019, 45 (02) :220-222
[33]   Multicenter Emergency Department Validation of the Canadian Syncope Risk Score [J].
Thiruganasambandamoorthy, Venkatesh ;
Sivilotti, Marco L. A. ;
Le Sage, Natalie ;
Yan, Justin W. ;
Huang, Paul ;
Hegdekar, Mona ;
Mercier, Eric ;
Mukarram, Muhammad ;
Nemnom, Marie-Joe ;
McRae, Andrew D. ;
Rowe, Brian H. ;
Stiell, Ian G. ;
Wells, George A. ;
Krahn, Andrew D. ;
Taljaard, Monica .
JAMA INTERNAL MEDICINE, 2020, 180 (05) :737-744
[34]   Predicting Short-term Risk of Arrhythmia among Patients With Syncope: The Canadian Syncope Arrhythmia Risk Score [J].
Thiruganasambandamoorthy, Venkatesh ;
Stiell, Ian G. ;
Sivilotti, Marco L. A. ;
Rowe, Brian H. ;
Mukarram, Muhammad ;
Arcot, Kirtana ;
Kwong, Kenneth ;
McRae, Andrew D. ;
Wells, George A. ;
Taljaard, Monica .
ACADEMIC EMERGENCY MEDICINE, 2017, 24 (11) :1315-1326
[35]   Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope [J].
Thiruganasambandamoorthy, Venkatesh ;
Kwong, Kenneth ;
Wells, George A. ;
Sivilotti, Marco L. A. ;
Mukarram, Muhammad ;
Rowe, Brian H. ;
Lang, Eddy ;
Perry, Jeffrey J. ;
Sheldon, Robert ;
Stiell, Ian G. ;
Taljaard, Monica .
CANADIAN MEDICAL ASSOCIATION JOURNAL, 2016, 188 (12) :E289-E298
[36]   Prognostic value of cardiac biomarkers in the risk stratification of syncope: a systematic review [J].
Thiruganasambandamoorthy, Venkatesh ;
Ramaekers, Rosa ;
Rahman, Mohammed Omair ;
Stiell, Ian Gilmour ;
Sikora, Lindsey ;
Kelly, Sarah-Louise ;
Christ, Michael ;
Claret, Pierre-Geraud ;
Reed, Matthew James .
INTERNAL AND EMERGENCY MEDICINE, 2015, 10 (08) :1003-1014
[37]   Emergency department management of syncope: need for standardization and improved risk stratification [J].
Thiruganasambandamoorthy, Venkatesh ;
Taljaard, Monica ;
Stiell, Ian G. ;
Sivilotti, Marco L. A. ;
Murray, Heather ;
Vaidyanathan, Aparna ;
Rowe, Brian H. ;
Calder, Lisa A. ;
Lang, Eddy ;
McRae, Andrew ;
Sheldon, Robert ;
Wells, George A. .
INTERNAL AND EMERGENCY MEDICINE, 2015, 10 (05) :619-627
[38]   OUTCOMES IN CANADIAN EMERGENCY DEPARTMENT SYNCOPE PATIENTS - ARE WE DOING A GOOD JOB? [J].
Thiruganasambandamoorthy, Venkatesh ;
Hess, Erik P. ;
Turko, Ekaterina ;
Perry, Jeffrey J. ;
Wells, George A. ;
Stiell, Ian G. .
JOURNAL OF EMERGENCY MEDICINE, 2013, 44 (02) :321-328
[39]   Syncope Prognosis Based on Emergency Department Diagnosis: A Prospective Cohort Study [J].
Toarta, Cristian ;
Mukarram, Muhammad ;
Arcot, Kirtana ;
Kim, Soo-Min ;
Gaudet, Sarah ;
Sivilotti, Marco L. A. ;
Rowe, Brian H. ;
Thiruganasambandamoorthy, Venkatesh .
ACADEMIC EMERGENCY MEDICINE, 2018, 25 (04) :388-396
[40]   History taking as a diagnostic test in patients with syncope: developing expertise in syncope [J].
Wieling, Wouter ;
van Dijk, Nynke ;
de Lange, Frederik J. ;
Nordkamp, Louise R. A. Olde ;
Thijs, Roland D. ;
van Dijk, J. Gert ;
Linzer, Mark ;
Sutton, Richard .
EUROPEAN HEART JOURNAL, 2015, 36 (05) :277-280