Clinical Case Database / Category: Patient Management


Publication details

Dr Joe Sawyer, Dr Mark J Dayer
Foundation Years Journal, volume 8, issue 2, p.48 (123Doc Education, London, February 2014)


Syncope is defined as a transient loss of consciousness and is a specific term that excludes seizures, coma, shock or other altered states of consciousness. It is extremely common and frequently presents to the emergency department. Evaluation of the event through a detailed medical history will form the basis of the diagnostic strategy and will enable the stratification of patients according to risk.

This article provides a simple approach on how to assess, investigate and evaluate patient risk. Furthermore we categorise syncope into its different causes providing a diagnostic framework and management plan for each. Some syncopal episodes may be easily diagnosed on history alone whereas others may require a careful diagnostic workup involving specialist input.

The management of syncope is entirely dependant on the cause and can vary from supportive measures to invasive procedures. This highlights the importance of the initial history and subsequent diagnostic investigations.

This article will provide junior doctors with the confidence to manage syncope in the busy emergency department allowing them to make important decisions on whether to admit or discharge.

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Dr Joe Sawyer

FY2, Accident and Emergency Department,
Taunton and Somerset NHS Trust, Musgrove Park, Taunton, TA1 5DA

Dr Mark J Dayer

Consultant Cardiologist,
Taunton and Somerset NHS Trust, Musgrove Park, Taunton, TA1 5DA


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.