The differential diagnosis of syncope: a guide for emergency department advanced practice nurses

Syncope is common in patients presenting in the emergency department, and it is essential that advanced practice nurses (APNs) be able to quickly and efficiently risk-stratify these patients. The importance of a thorough and accurate history and physical examination cannot be understated in diagnosing the pathology of syncope. Although vasovagal syncope is the most common cause of syncope, it is important to rule out the life-threatening causes of syncope first. APNs working in emergency departments can determine what pertinent diagnostic studies need to be ordered and which consults should be considered in patients presenting with syncope. APNs can also decide whether an inpatient admission is warranted or whether the patient can be safely discharged with outpatient follow-up. The importance of the history and physical examination as the best tool that APNs can use has been highlighted. Finally, implications for APNs in treating patients presenting with syncope are discussed.