In-hospital management of syncope
Szegedi Tudományegyetem, Aneszteziológiai és Intenzív Terápiás Tanszék, Szeged
Syncope is a common medical problem. Although in certain cases syncope could be the manifestation of a life threatening cardiovascular disease, the first assessment of syncope victims is seldom performed by a cardiologist. They often present at the emergency department. Several studies indicate that syncope management in the everyday clinical practice is heterogeneous, and ineffective. An effective syncope workup should start at the emergency departments by selecting optimal management pathways. Diagnostic and therapeutic guidelines issued by various professional organizations can direct our approach, however it is necessary to implement guideline based local algorithms. Dedicated syncope observation units within the emergency department facilitate syncope management while the rate of hospitalization and the cost of care could be reduced. Another new option is the foundation of syncope management units. These units, led by syncope specialists, function as outpatient facilities with special staffing requirements and equipments. Patients from the emergency departments, hospital wards and from family practices could be referred to the syncope management units. Systematic utilization of the above elements could provide comprehensive and effective syncope care.