This is Steve Carroll and you're listening to the EM Basic podcast. In this episode, we're going to talk about syncope.

This is something that we deal with a lot, and while most causes of syncope aren't anything to worry about,

we need to find those people who have potentially serious causes of syncope or passing out.

For a bonus section, at the request of a listener, we'll talk a little bit about how to

rehydrate patients in the ED. As always, this podcast doesn't represent the views or opinions of

the Department of Defense, the U.S. Army, or the Shawshack Emergency Medicine Residency.

As always, pay attention to the vital signs on the chart.

Hypotension or tachycardia can be worrisome signs in a patient with syncope.

Before we talk about how to take the all-important history, we need to talk about the definition

of synchemy. Synchemy is defined as a rapid loss of consciousness, followed by a rapid return to

baseline. The biggest mistake that we make here is the rapid return to baseline part.

If the patient doesn't wake up

immediately after they pass out, then it's not syncope and it needs to be investigated in a much

different manner. Also, if the patient has any other symptoms like chest pain, headache, or seizure

activity, then this needs to be investigated in a much different manner. To illustrate this

point, I'll actually use myself as an example.

A few years ago, I passed out on a flight.

Before I left that morning for the flight, I worked out at the gym and ate a large lunch of Mexican food before I got on the plane.

No alcohol, I swear.

I fell asleep on the plane with the sun shining directly through the window, and when I woke

up I felt awful. I felt hot and flushed. I felt nauseous and dizzy. I honestly have never felt so

awful my entire life. I got up to go to the bathroom in the back of the plane and made it about

...