[Terms in use for transient loss of consciousness in the emergency ward; an inventory]

To investigate the terminology for transient loss of consciousness in use in a Dutch emergency ward and to compare it with European definitions.

Descriptive.

The records of all consecutive patients seen during an eight-week period in the Emergency Clinic of Leiden University Medical Centre, the Netherlands, were reviewed. Patients were enrolled in one of the following Dutch terms was encountered, expressing either a specific form or a general description of non-traumatic transient loss of consciousness (TLOC): 'collaps' (collapse), 'syncope' (syncope), 'flauwvallen' (fainting), 'wegraking' (TLOC) and 'insult' (seizure). The use of these terms was compared with the definitions of the European Society of Cardiology (ESC).

The prevalence of a non-traumatic TLOC diagnosis in the Emergency Clinic was 2.9% (123/4300). 'Collaps' was the most frequently used term (53%), followed by 'insult' (31%), 'wegraking' (11%), 'flauwvallen' (3%) and 'syncope' (2%). The term 'collaps' was found to have been used in the context of the ESC category 'syncope' (n=47), TLOC (n=5), 'no TLOC' (n=9) or for situations that could not be classified (n=4). The term 'insult' was used exclusively in the context of epilepsy and the term 'syncope' exclusively in the context of the ESC category 'syncope'. The term 'wegraking' proved to have been used in the context of the ESC category 'TLOC' (n=11), 'epilepsy' (n=1) or for situations that could not be classified (n=1). 'Flauwvallen' was used in the context of the ESC category 'syncope' (n=3) or the category 'no TLOC' (n=1).

It would be advisable to give the terms mentioned above a specific meaning: reserve 'collaps' for a fall without an obvious external cause, 'wegraking' for transient loss of consciousness without a clear cause, and 'syncope' for loss of consciousness due to temporary low cerebral blood flow.