title: Opportunities for Emergency Medical Services (EMS) Care of Syncope.
abstract: Introduction Emergency Medical Service (EMS) systems are vital in the identification, assessment, and treatment of trauma, stroke, myocardial infarction, and sepsis patients, improving early recognition, resuscitation, and transport. Emergency Medical Service personnel provide similar care for patients with syncope. The role of EMS in the management of patients with syncope has not been reported. Hypothesis/Objective The objective of this study was to describe the management of out-of-hospital syncope by prehospital providers in an urban EMS system.
  
  
  METHODS
  This was a retrospective cohort study of consecutively enrolled patients over 18 years of age, over a two-year period, who presented by EMS with syncope, or near-syncope, to a tertiary care emergency department (ED). Demographics included comorbidities, history, and physical exam findings documented by prehospital providers, as well as the interventions provided. Data were collected from standardized patient care records for descriptive analysis.
  
  
  RESULTS
  Of the 723 patients presenting with syncope to the ED, 284 (39.3%) were transported by EMS. Compared to non-EMS patients, those who arrived by ambulance were older (mean age 65 [SD = 18.5] years versus 61 [SD = 19.2] years; P = .019). There were no statistically significant differences in cardiovascular comorbidities (hypertension, coronary artery disease, diabetes mellitus, stroke, or congestive heart failure) between EMS and non-EMS patients. The most common chief complaints were fainting (50.0%) and dizziness (44.7%). The most common intervention provided was cardiac monitoring (55.6%), followed by administration of normal saline infusion (50.5%), oxygen (41.9%), blood glucose check (41.5%), and electrocardiogram (EKG; 40.5%).
  
  
  CONCLUSIONS
  Emergency Medical Service personnel transport more than one-third of patients presenting to the ED with syncope. Documentation of key elements of the history (witnesses, prodrome, predisposing factors, and post-event symptoms) and physical examination were not recorded consistently. Long BJ , Serrano LA , Cabanas JG , Bellolio MF . Opportunities for Emergency Medical Services (EMS) care of syncope. Prehosp Disaster Med. 2016;31(4):349-352.
authors.affiliation: 1Mayo Clinic College of Medicine,Department of Emergency Medicine,Rochester,MinnesotaUSA.
authors.forename: Brit J
authors.initials: BJ
authors.lastname: Long
authors.affiliation: 1Mayo Clinic College of Medicine,Department of Emergency Medicine,Rochester,MinnesotaUSA.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Serrano
authors.affiliation: 2Austin Travis County Emergency Medical Services,Austin,TexasUSA.
authors.forename: Jose G
authors.initials: JG
authors.lastname: Cabanas
authors.affiliation: 1Mayo Clinic College of Medicine,Department of Emergency Medicine,Rochester,MinnesotaUSA.
authors.forename: M Fernanda
authors.initials: MF
authors.lastname: Bellolio
mesh_terms: D000368:Aged; D015897:Comorbidity; D004632:Emergency Medical Services / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D012189:Retrospective Studies; D013575:Syncope / Q000453:epidemiology / Q000628:therapy*; D014187:Transportation of Patients / Q000379:methods / Q000706:statistics & numerical data
keywords: ED emergency department; EKG electrocardiogram; EMS; EMS Emergency Medical Service; cardiovascular; syncope