Podcast # 490: Canadian Syncope Rule - The Emergency Medical Minute

Contributor: Don Stader, MD

Educational Pearls:

  • Syncope is usually benign but can be caused by serious etiologies which include: PE, certain cardiac arrhythmias, AAA, intracranial bleed/stroke
  • The Canadian Syncope Rule appears to identify those patients with syncope and low risk of serious outcomes
  • The score is based on vital signs, EKG and history
  • Negative scores preclude a very low risk of adverse events
  • A calculated score greater than 1 are considered medium risk
  • Scores greater than 4 are high risk
  • Anyone with a medium risk or higher should have their cause thoroughly investigated – which may involve admission or a shared decision making utilizing this rule if discharged

Editor’s note: just remember this rule has not been externally validated… yet

References

https://www.mdcalc.com/canadian-syncope-risk-score

Thiruganasambandamoorthy V, Kwong K, Wells GA, et al. Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope. CMAJ. 2016;188(12):E289–E298. doi:10.1503/cmaj.151469

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD

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