Syncope Risk Stratification in the Emergency Department

Abstract

An 89-year-old What steps should be taken to deal with a patient presenting at the ED because of a transient loss of consciousness? THE FIRST STEP: IDENTIFYING PATIENTS WITH SYNCOPETo identify the patient with syncope, 3 major issues have to be addressed:Distinguish patients with syncope from those with a transient loss of consciousness (T-LoC) of nonsyncopal origin Differentiate patients with syncope from those having falls Determine how to manage patients presenting with near syncopeThe authors have nothing to disclose.

Developmental and Initial Validation of the Pulmonary Arterial Hypertension Symptom Interference Scale

“…Signs are observable abnormalities in a person (Stedman, 2008), whereas symptoms are subjective experiences in perceptions of biological and psychosocial function (Dodd et al, 2001). The model incorporates the symptom experience, components of symptom management strategies, and outcomes.…”

“…These are common symptoms in patients with right-sided heart failure which can occur with PAH (Sachdev et al, 2011). The PAHSIS supports two dimensions of the model: symptom experience and outcomes (Dodd et al, 2001). Regarding the symptom experience, the PAHSIS can assess the perception of symptoms and how symptoms interfere the patient's life.…”

“…Syncope is a significant finding in PAH and is important to assess because it is a poor prognostic sign in PAH (Kawut et al, 2009). In addition, there are safety concerns resulting in injury if patient's fall during a syncopal event (Costantino & Furlan, 2013).…”

“…The symptom experience includes the perception and response to symptoms, whereas symptom management strategies include what interventions is employed, by whom, and how much. The outcomes include measures of functional status, emotional status, and quality of life (Dodd et al, 2001).…”

“…The University of California San Francisco (UCSF) symptom management conceptual model (Dodd et al, 2001) was used to guide the development of the Pulmonary Arterial Hypertension Symptom Interference Scale (PAHSIS). Signs are observable abnormalities in a person (Stedman, 2008), whereas symptoms are subjective experiences in perceptions of biological and psychosocial function (Dodd et al, 2001).…”