Prehospital treatment of syncope

Abstract

Syncope is a reversible loss of consciousness occuring as a result of cerebral hypoperfusion and is characterized by a quick onset, short duration and a spontaneous and complete recovery. It is often the reason for calling 194 and makes up 3% of all interventions in the field. Regarding what caused it, it can be: reflex syncope (neuronal cause), caused by orthostatic hypotension and cardiovascular syncope. It can be caused by anything from benign factors to life threatening conditions. Patients with vasovagal syncope are not expected to have a resulting rise in morbidity and mortality, but patients with cardiovascular syncope have a 30% greater risk of sudden death during the following year. Initial prehospital evaluation of a patient with transitory loss of consciousness includes taking medical history, performing a physical examination, measuring blood pressure and recording an ECG. The initial evaluation defines the cause of the syncope in 23-50% od the patients. In most cases, minimal prehospital treatment is needed. Therapy depends on the cause of the syncope and risk assesment. It is necessary to evaluate the airway, breathing and circulation and treat life-threatening conditions. The patient should be prepared for transport and transported to the hospital. The patient's vital functions should be continuously monitored.

Keywords

• transitory loss of consciousness
• syncope
• emergency medical service
• initial assessment
• treatment