Author: Matthew J Dunn / Editor: Jason Kendall / Reviewer: Suzy Connor, Amanda King / Codes: / Published: 15/11/2021

This session is about assessment and management of patients presenting with transient loss of consciousness to the emergency department. This is a very common presentation which presents the emergency physician with significant diagnostic challenges, not least of which because the patient has, by definition, recovered from the index event.

After completing this session, you will be able to:

  • Recognise the common cause of syncope
  • Understand the epidemiology of syncope
  • Risk stratify patients presenting with syncope
  • Plan and interpret appropriate investigations in patients with syncope
  • Determine which patients require admission and which can be safely discharged from the emergency department


  1. Soteriades ES, Evans JC, Larson MG, et al., Incidence and prognosis of syncope. N Engl J Med. 2002 Sep 19;347(12):878-85.
  2. Colivicchi F, Ammirati F, Melina D, Guido V, Imperoli G, Santini M; OESIL (Osservatorio Epidemiologico sulla Sincope nel Lazio) Study Investigators. Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: the OESIL risk score. Eur Heart J. 2003 May;24(9):811-9.
  3. Quinn J, McDermott D, Stiell I, Kohn M, Wells G. Prospective validation of the San Francisco Syncope Rule to predict patients with serious outcomes. Ann Emerg Med. 2006 May;47(5):448-54.
  4. Del Rosso A, Ungar A, Maggi R, et al., Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital: the EGSYS score. Heart. 2008 Dec;94(12):1620-6.
  5. National Institute for Health and Care. Transient loss of consciousness (‘blackouts’) in over 16s; [NICE guideline CG109]. Published: 2010, Updated: 2014.

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