Management of transient loss of consciousness of suspected syncopal cause, after the initial evaluation in the Emergency Department

  • Ivo Casagranda | casagranda@libero.it Syncope Unit, Emergency Department, Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
  • Michele Brignole Syncope Unit, Cardiology Department, Tigullio Hospitals, Lavagna, Italy.
  • Simone Cencetti Syncope Unit, Emergency Department, S. Maria Nuova Hospital, Florence, Italy.
  • Gianfranco Cervellin Emergency Department, University Hospital of Parma, Parma, Italy.
  • Giorgio Costantino Allergology and Clinical Immunology Department, Niguarda Ca’ Granda Hospital, Milan, Italy.
  • Raffaello Furlan Syncope Unit, Internal Medicine Department, Humanitas Institute, Rozzano, Italy.
  • Gianluigi Mossini Emergency Department, University Hospital of Parma, Parma, Italy.
  • Filippo Numeroso Emergency Department, University Hospital of Parma, Parma, Italy.
  • Massimo Pesenti Campagnoni Syncope Unit, Emergency Department, Regional Hospital Umberto Parini, Aosta, Italy.
  • Paolo Pinna Parpaglia Syncope Unit, Emergency Department, SS. Annunziata Hospital, Sassari, Italy.
  • Martina Rafanelli Syncope Unit, Geriatric Cardiology and Medicine Unit, University Hospital of Careggi, Florence, Italy.
  • Andrea Ungar Syncope Unit, Geriatric Cardiology and Medicine Unit, University Hospital of Careggi, Florence, Italy.

Abstract

The recommendations enclosed in the present document have been developed by a group of experts appointed by the Gruppo Multidisciplinare per lo Studio della Sincope (Multidisciplinary Group for the Study of Syncope; GIMSI) and Academy of Emergency Medicine and Care (AcEMC). The aim is to define the diagnostic pathway and the management of patients referred to the Emergency Department (ED) for transient loss of consciousness of suspected syncopal cause, which is still unexplained after the initial evaluation. The risk stratification enables the physician to admit, discharge or monitor shortly the patient in the intensive short-stay Syncope Observation Unit (SOU). There are three risk levels of life-threatening events or serious complications (low, moderate, high). Low risk patients can be discharged, while high risk ones should be monitored and treated properly in case of worsening. Moderate risk patients should undergo clinical and instrumental monitoring in SOU, inside the ED. In all these three cases, patients can be subsequently referred to the Syncope Unit for further diagnostic investigations.

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Published
2016-06-29
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Section
Opinion Reports
Keywords:
Transient loss of consciousness, Syncope, Emergency Department
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How to Cite
Casagranda, I., Brignole, M., Cencetti, S., Cervellin, G., Costantino, G., Furlan, R., Mossini, G., Numeroso, F., Pesenti Campagnoni, M., Pinna Parpaglia, P., Rafanelli, M., & Ungar, A. (2016). Management of transient loss of consciousness of suspected syncopal cause, after the initial evaluation in the Emergency Department. Emergency Care Journal, 1(1). https://doi.org/10.4081/ecj.2016.6046