Passing Out Made Ridiculously Simple . . . or at Least Somewhat Simpler

Syncope accounts for about 5% of emergency department (ED) visits and about 3% of hospital admissions. Although many attempts have been made to guide diagnostic and prognostic evaluation of syncope, few researchers have reviewed the literature systematically to evaluate prognostic factors and clinical decision rules. Four recent publications help fill this gap.

The National Institute for Health and Clinical Excellence (NICE) Guideline for Management of Transient Loss of Consciousness emphasizes the value of history and physical examination findings in predicting uncomplicated faints (e.g., vasovagal episodes) and in distinguishing seizure from syncope. Uncomplicated faints are suggested by three Ps: posture (occurs during prolonged standing …