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

<p><b>EMplify - June 2021</b></p> <p><b>Announcements:</b></p> <ol> <li>The Clinical Decision Making in the Emergency Department conference is June 23-27 live and virtual. More information here: https://clinicaldecisionmaking.com</li> <li>Be on the lookout for an announcement regarding the new EB Medicine app, coming to an App Store near you this summer !!</li> </ol> <p><b>Syncope- An Interview With Dr. James Morris</b></p> <p>See the EB Medicine Article @ https://www.ebmedicine.net/topics/cardiovascular/syncope</p> <ol> <li>Why syncope? Prevalence, hospitalizations, etc.</li> <li>Etiology: figure 1 is fantastic. Physiologic basis of syncope<ol> <li> Neurally mediated</li> <li>Orthostatic - are we still doing orthostatic vitals in the ED?</li> <li>Cardiac </li> </ol></li> <li>Differentiating syncope from seizure<ol> <li>Features that point to seizure</li> <li>Urinary incontinence</li> <li>Number of jerks</li> <li>Age?</li> </ol></li> <li>Prehospital care is all about details<ol> <li>What did bystanders see?</li> <li>What do paramedics see?</li> <li>Any trauma?</li> <li>Any neuro deficits ?</li> <li>Glucose </li> <li>ECG</li> </ol></li> <li>ED  History - table 4<ol> <li>History of similar</li> <li>Prodrome</li> <li>Associated symptoms (chest pain, neuro symptoms, etc)</li> <li>Falls</li> <li>Pre-syncope ?</li> </ol></li> <li>ED exam<ol> <li>Vitals, vitals, vitals</li> <li>Orthostatic vitals ?</li> <li>Carotid sinus massage, why this? Do we do in the ED?</li> </ol></li> <li>ECG<ol> <li>Brugada, blocks, VT, ST changes, etc</li> </ol></li> <li>Labs<ol> <li>BNP, delta bnp ?</li> <li>Trop</li> <li>Lactic acid</li> <li>Pregnancy test</li> <li>CBC</li> <li>lutes</li> <li>Bun/Cr</li> </ol></li> <li>Echo - any role in the ED?</li> <li>CT<ol> <li>Head</li> <li>PE- get this on everyone ? Is it high prevalence?</li> </ol></li> <li>Risk stratification tools- the bad and the worse</li> <li>Table 7, amazing</li> <li>Controversies<ol> <li>Admitting the elderly </li>