Managing Syncope/Collapse in the Emergency Department

Research output: Chapter in Book/Report/Conference proceedingChapter


This chapter focuses on the management of syncope and collapse in the Emergency Department (ED). Syncope is a common reason for ED attendance and it presents a major management challenge with regard to the appropriate workup and disposition. Initially a diagnosis of syncope should be made considering other syncope mimics that can present with Transient Loss Of Consciousness (TLoC) especially seizure, and other causes of collapse such as presyncope, lightheadedness, vertigo, disequilibrium and mechanical fall. Once the presenting syndrome of syncope is established, the current suggested approach to the syncope patient as advocated by the 2018 European Society of Cardiology (ESC) syncope guidelines should be followed. If no obvious underlying cause for the event is found, risk stratification should be undertaken to determine which patients likely have benign causes of syncope and which are at high risk of short-term and long-term adverse outcome. Red flag symptoms should be checked and driving, working, and avocational implications should be fully considered according to local protocols. The benefits of a hospital syncope clinical decision unit and a rapid access syncope clinic include reduced admissions, reduced length of hospital stay and reduced hospital costs.
Original languageEnglish
Title of host publicationSyncope
Subtitle of host publicationAn Evidence-Based Approach
EditorsMichele Brignole, David G. Benditt
PublisherSpringer International Publishing AG
ISBN (Electronic)978-3-030-44507-2
ISBN (Print)978-3-030-44506-5
Publication statusPublished - 30 Jun 2020


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