Grand Rounds Recap 02.17.21

Grand Rounds Recap 02.17.21

This week Dr. Koehler has great teaching points on epistaxis, PRES and more during M&M. Dr. McMullan recounts a harrowing tale of compassion in a case follow up. Dr. Wosiski-Kuhn gives a timely reminder on carbon monoxide and cyanide toxicities followed by Dr. Roblee’s acidotic arrest case and Dr. Lane wraps up with some business need-to-knows of EM.

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Falling Out - Syncope Evaluation in the Emergency Department

Falling Out - Syncope Evaluation in the Emergency Department

Syncope is a common presenting complaint to the emergency department. Estimates suggest that 1- 3 percent of ED visits are for syncope.(1) While the large majority of these episodes are often benign, they can suggest underlying life-threatening etiologies such as arrhythmias, pulmonary embolism, and stroke. The disposition of these patients can represent a difficult quandary at times. In fact, emergency physicians are only able to establish a clear underlying diagnosis in approximately 50% of syncope patients after obtaining an HPI, physical exam and ECG. (2

Should these patients be observed in the ED? And, if so, for how long? Should they be admitted to the hospital for further workup and observation? Should they instead be discharged home with close follow-up? 

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