Syncope Flashcards
In syncope, want to rule out ___as soon as possible
Trauma
Life threats you want to rule out with syncope
Cardiac, Neurological event, respiratory issue, volume issue, metabolic issue (4 life threats: shock, cardiac, respiratory, neuro)
Syncope
Temporary insufficient perfusion of the brain
Temporary loss of consciousness and posture
What life threat should you rule out first with the elder population?
Cardiac
Reasons for syncope with cardiac issue?
Palpitations (females especially), MI, Dysrhythmias
Types of dysrhythmias that may result in syncope?
SVT (supraventricular tachycardia)
VT (ventricular tachycardia)
Bradycardia
Atrial fibrillation
“Fluttering in the chest” is associated with what type of dsyrhythmia?
Atrial fibrillation
Syncope that may result from a neuro event?
Cerebral vascular accident (CVA)
Transient Ischemic Accident(TIA)
What does a stroke most commonly result from?
Thrombosis (occulsive or aneurysm)
What type of assessment would you perform on a stroke patient?
FAST ED
Respiratory issue associated with syncope?
Pulmonary embolus
Syncope from a volume issue?
Hemmorhage
Dehydration
You may want to do what to rule out a volume issue?
Orthostatic vital signs
Syncope from metabolic issue?
Hypoglyemia
Hormonal-pregnancy
What makes something non-life threatening?
Transient and self resolving
Non-life threatening syncopal issues?
Vasovagal
Prolonged/sudden standing
Environmental components
Psychogenic
Why would prolonged standing result in a syncopal episode?
Mechanism for moving blood up the viens is muscle movement. if not moving for a long period, blood is not making its way up
Common pre-syncopal events (these complaints do not throw up a “red flag”)
Dizziness Unsteady/weakness Diaphoresis Greying of peripheral vision Brief period of seizure activity not unusual (incontinence/post ictal period is rare)
Difference between normal seizure patient and syncopal episode?
Presence of incontinence and post ictal period
Assessment for syncopal episode?
ABC's Trauma? Reliable witness Vital signs Postural (if patient seems stable) PMH: Meds
Assessment, life threats:
Cardiac assessment Respiratory assessment (oximetry) Neuro assessment (rule out seizure) Glucometry Abdominal assessment
Red flags for syncopal episode
Elderly
Syncope at rest (without position change)
Syncope without warning (cardiac and hemorrhage in play)
Cardiac symptoms
Prolongued syncope (cardiac or neuro-position change increases bloodflow to the brain, so should change condition. If not, consider cardiac/neuro)
Seizure
Truama
Pertinent negatives
Cardiac: SOB pre or post syncope, Chest pain, Palpitations
Seizure: Incontinence
Trauma: head injury pre or post event
What should be documented for syncopal episode, especially when considering potential trauama
Need to document whether or not patient has injury and if the patient went to ground
Treatment of syncopal episode
O2
Position
Trauma management
Consider ALS
