[Syncope in prehospital emergency medicine]

Area of Science:

• Emergency Medicine
• Cardiology
• Prehospital Care

Background:

• Loss of consciousness is a common reason for emergency medical services (EMS) calls.
• It can indicate serious, life-threatening conditions.
• Distinguishing transient loss of consciousness (TLOC) from syncope of cardiovascular origin is crucial.

Purpose of the Study:

• To outline the prehospital assessment and management of patients with loss of consciousness.
• To identify risk factors necessitating hospital admission.
• To define criteria for safe initial management without emergency department admission.

Main Methods:

• Utilizing the ABCDE algorithm for initial assessment in prehospital emergency care.
• Performing a 12-lead electrocardiogram (ECG) as part of the initial assessment.
• Evaluating for specific risk factors indicative of serious underlying conditions.

Main Results:

• The presence of risk factors like supine position, physical stress, palpitations, cardiac history, or ECG abnormalities warrants hospital admission.
• Patients without risk factors, injuries, with normal vital signs, and likely orthostatic etiology may be managed initially without emergency department admission.

Conclusions:

• Prehospital assessment using the ABCDE algorithm and ECG is vital for managing loss of consciousness.
• Risk stratification is key to determining the appropriate disposition for patients with TLOC.
• Careful patient selection allows for initial management outside the emergency department for low-risk cases.