The Syncope Core Management Process in the Emergency Department: Consensus Statement

The EUSEM Syncope Group have published a consensus statement in the European Journal of Emergency Medicine on the general process of the workup and care for patients with suspected syncope, providing rules for sufficient and systematic management of the broad group of syncope (initially presenting as TLOC) patients in the ED. A variety of European diagnostic and therapeutic standards for syncope patients were reviewed and summarized in three rounds of a modified Delphi process by the European Society for Emergency Medicine Syncope Group. Based on a consensus statement, a detailed process pathway was created. The primary outcome of this work is the presentation of a universal process pathway for the structured management of syncope patients in European EDs. The presented extended event process chain (eEPC) summarizes and homogenizes the process management of European ED syncope patients. Additionally, an exemplary translation of the eEPC into a practice-based flowchart algorithm, which can be used as an example for practical use in the ED, is provided in this work. Syncope patients, initially presenting with TLOC, are common and pose challenges in the ED. Despite variations in process management across Europe, the development of a universally applicable syncope eEPC in the ED was successfully achieved. Key features of the consensus and eEPC include ruling out life-threatening causes, distinguishing syncope from nonsyncopal TLOCs, employing syncope risk stratification categories and based on this, making informed decisions regarding admission or discharge.

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