Syncope is an incredibly common presentation to the Emergency Department with a broad differential diagnosis from the benign (vasovagal) to the lethal (arrhythmia). Because of this, the care and disposition of these patients can be challenging. In this podcast we sat down with Dr. Mike Burla to talk through the details of a new(er) decision aid- the Canadian Syncope Risk Score.

The paper we discuss can be found HERE

Thiruganasambandamoorthy V et al. Duration of Electrocardiographic Monitoring of Emergency Department Patients With Syncope. Circulation. 2019 Mar 12;139(11):1396-1406.

Check out our post on the Down East EM blog for shownotes, references, and more.

When listening to this post, please consider the following questions (and follow us on twitter for spaced retrieval of this material @downeastem):

1. How long did the CSRS study investigators observe patients for major arrhythmic outcomes after presentation to the ED? 

2. Approximately what percentage of the study cohort was classified as low risk by the CSRS?

3. What proportion of serious arrhythmic outcomes occurred within 6 hours of ED arrival, regardless of CSRS score? 

4. According to the study authors, what is the recommended time for observation of a low risk patient by CSRS? How about for Medium and High Risk Patients? 

5. Based on the study results, what risk stratification category are the recommendations most applicable to? What is the recommendation for electrocardiographic monitoring of this group? 

Authors: Mike Burla MD and Jason Hine MD

Peer Review: Lauren Wendell MD