PROTOCOL 2.29: SYNCOPAL EPISODE

Note: Syncope is by definition a transient state of unconsciousness from which the patient has recovered. If the patient is still unconscious, see Coma/Altered Mental Status Protocol. Emphasis should be placed on underlying cause of syncope and its treatment.

Statistically, the most common cause of unconsciousness in the elderly patient in the pre-hospital setting is CVA/stroke problems. In the younger patient it is seizures.

ADULT CARE

1. General Supportive Care.

2. ECG. IV NS if patient remains not alert.

3. Consider possible need for cervical spine immobilization if patient sustained fall during syncope.

4. Carefully monitor for any neurological deficits. Be aware of Medical Alert tags, breath odor, signs of drug abuse, sources of gases, potential toxins or ingestions.

5. Consider past medical history and possibility of transient dysrhythmia, hypovolemia (check for orthostatic changes in vital signs), medication side effects, glucose level abnormalities, inner ear disorders, CVA/TIA.

6. The patient that has passed out and then regained consciousness will frequently want to refuse service. Make sure patient has received full assessment (vitals, ECG, glucose check) and remind them that passing out is not normal before processing such a refusal, refer to No Transport (Refusal, Cancel) Protocol.

Level II.1. None.

PEDIATRIC CARE

1. General Supportive Care.

2. ECG. IV NS if patient remains not alert.

3. Consider possible need for cervical spine immobilization if patient sustained hard fall during syncope.

PROTOCOL 2.29: SYNCOPAL EPISODE (cont.)

PEDIATRIC CARE (cont.)

4. Carefully monitor for any neurological deficits. Be aware of Medical Alert tags, breath odor, signs of drug abuse, sources of gases, potential toxins or ingestions.

5. Consider past medical history and possibility of transient dysrhythmia, hypovolemia (check for orthostatic changes in vital signs), medication side effects, glucose level abnormalities, inner ear disorders, CVA/TIA.

6. The parents of a pediatric patient that has passed out and then regained consciousness may want to refuse service. Make sure patient has received full assessment (vitals, ECG, glucose check) and remind them that passing out is not normal before processing such a refusal, refer to No Transport (Refusal, Cancel) Protocol.

Level II.1. None.