Post by Bjs04f on Jun 17, 2015 10:50:20 GMT -5
emlyceum.com/2015/06/17/syncope-answers
A few very interesting take aways:
1- multiple times been told to get a head CT despite saying its low yield, this verifies this
2-ekg alone appear appropriate to negate need for trop as it will be negative if ekg is normal, barring a different diagnosis(PE, Dissection), which I dont use trop to look for anyways
3-orthostatics suck, man so many times has the admitting doc gone but they arent orthostatic how can you tell me theyre dehydrated. It true you look at the pt and go he clearly had orthostatic syncope from volume depletion, but it didnt show on our ED orthos, heres why its sensitivity is on par with D dime for super high risk PE, complete crap.
4- this was interesting, as I have always risk stratified near syncope down with nml walk in exam, but clearly need to rethink it. I like how they describe it on a spectrum from near syncope to arrest, its a good way to think of it.
A few very interesting take aways:
1- multiple times been told to get a head CT despite saying its low yield, this verifies this
2-ekg alone appear appropriate to negate need for trop as it will be negative if ekg is normal, barring a different diagnosis(PE, Dissection), which I dont use trop to look for anyways
3-orthostatics suck, man so many times has the admitting doc gone but they arent orthostatic how can you tell me theyre dehydrated. It true you look at the pt and go he clearly had orthostatic syncope from volume depletion, but it didnt show on our ED orthos, heres why its sensitivity is on par with D dime for super high risk PE, complete crap.
4- this was interesting, as I have always risk stratified near syncope down with nml walk in exam, but clearly need to rethink it. I like how they describe it on a spectrum from near syncope to arrest, its a good way to think of it.
