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Opportunities for Emergency Medical Services (EMS) Care of Syncope

Published online by Cambridge University Press:  23 May 2016

Brit J. Long ,
Luis A. Serrano ,
Jose G. Cabanas  and
M. Fernanda Bellolio
Brit J. Long*
Affiliation:
Mayo Clinic College of Medicine, Department of Emergency Medicine, Rochester, Minnesota USA
Luis A. Serrano
Affiliation:
Mayo Clinic College of Medicine, Department of Emergency Medicine, Rochester, Minnesota USA
Jose G. Cabanas
Affiliation:
Austin Travis County Emergency Medical Services, Austin, Texas USA
M. Fernanda Bellolio
Affiliation:
Mayo Clinic College of Medicine, Department of Emergency Medicine, Rochester, Minnesota USA
*
Correspondence: Brit J. Long, MD 506 Dakota St APT 1 San Antonio, Texas USA E-mail: brit.long@yahoo.com
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Abstract

Introduction

Emergency Medical Service (EMS) systems are vital in the identification, assessment, and treatment of trauma, stroke, myocardial infarction, and sepsis patients, improving early recognition, resuscitation, and transport. Emergency Medical Service personnel provide similar care for patients with syncope. The role of EMS in the management of patients with syncope has not been reported.

Hypothesis/Objective

The objective of this study was to describe the management of out-of-hospital syncope by prehospital providers in an urban EMS system.

Methods

This was a retrospective cohort study of consecutively enrolled patients over 18 years of age, over a two-year period, who presented by EMS with syncope, or near-syncope, to a tertiary care emergency department (ED). Demographics included comorbidities, history, and physical exam findings documented by prehospital providers, as well as the interventions provided. Data were collected from standardized patient care records for descriptive analysis.

Results

Of the 723 patients presenting with syncope to the ED, 284 (39.3%) were transported by EMS. Compared to non-EMS patients, those who arrived by ambulance were older (mean age 65 [SD = 18.5] years versus 61 [SD = 19.2] years; P = .019). There were no statistically significant differences in cardiovascular comorbidities (hypertension, coronary artery disease, diabetes mellitus, stroke, or congestive heart failure) between EMS and non-EMS patients. The most common chief complaints were fainting (50.0%) and dizziness (44.7%). The most common intervention provided was cardiac monitoring (55.6%), followed by administration of normal saline infusion (50.5%), oxygen (41.9%), blood glucose check (41.5%), and electrocardiogram (EKG; 40.5%).

Conclusion

Emergency Medical Service personnel transport more than one-third of patients presenting to the ED with syncope. Documentation of key elements of the history (witnesses, prodrome, predisposing factors, and post-event symptoms) and physical examination were not recorded consistently.

LongBJ , SerranoLA , CabanasJG , BellolioMF . Opportunities for Emergency Medical Services (EMS) Care of Syncope. Prehosp Disaster Med. 2016;31(4):349–352.

Keywords

cardiovascularEMSsyncope
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 4 , August 2016 , pp. 349 - 352
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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