Unlocking Syncope: A Harbinger of Hidden Perils, Differentiating Benign from Life-Threatening Causes
Author: Ross Orpet, Paramedic turned EMS Physician
February 11, 2025
Duration: 59:01
Syncope is a symptom, not a diagnosis. Often it's a symptom of a benign etiology but it can indicate a life-threatening condition. So how do we distinguish between the two? We dive into the complex topic of syncope with guest Matt Mendes. We discuss the importance of recognizing syncope, differentiating it from seizures, and identifying who are the high-risk patients and why. The episode covers the guiding principles syncope- a good history, physical exam findings, and the ECG. It also delves into common presentations, risk stratifying strategies, and real-world cases to equip EMS providers with the knowledge needed to manage syncope calls effectively.
00:00 Intro
01:07 Welcome to EMS Cast, host and guest introductions
04:51 Guiding Principles for Syncope Assessment
07:22 High-Risk Syncope Patients
09:14 Initial Approach to Syncope Patients
15:15 Syncope vs. Seizure
20:08 Physical Exam and EKG Importance
25:14 Identifying Arrhythmias in Syncope Patients
26:37 Understanding Wolf Parkinson White Disease
27:46 QT Prolongation and Its Implications
29:49 Left Ventricular Hypertrophy and Its Risks
31:28 Recognizing Brugada Pattern
32:02 Arrhythmogenic Right Ventricular Dysplasia
33:04 Bifascicular Block and Its Dangers
35:00 EKG Interpretation and Syncope Risk Stratification
39:53 Emergency Department Workups for Syncope
55:49 Case Studies and Memorable Syncope Calls
Resources
The Resus Tailor
EMS Cast Syncope Blog Post
Other episodes you might like: Wide Complex Tachycardia
Podcast announcements- WE'RE RENAMING THE SHOW TO, LOUD & CLEAR: EMS GUIDING PRINCIPLES
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Guest/Cast/Crew information-Guest- Matt Mendes, EM doc, Resident didactics coordinator, former EMS Cast Co-HostHosts- Ross Orpet, Will Berry Catch up with us after the show
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Creative Commons - Attribution 3.0 Unported - CC BY 3.0Music sponsored by Audio Library https://youtu.be/JoyIRE5k2YoDaylight by Alex-Productions https://soundcloud.com/alexproductionsmusic