Syncope is one of the most common complaints we face in the ED. Most patients do well, yet a small subset are harboring serious cardiac or neurologic disease. Admit everyone, and we waste beds and resources; discharge everyone, and we risk missing life-threatening disease. As always in emergency medicine, we’re searching for the needle in the haystack—the one patient out of hundreds who’s truly at risk.
You may have heard of the San Francisco Syncope Rule, but have you met its worthy opponent, the Canadian Syncope Risk Score? When syncope isn’t straightforward, which tool should you trust to guide disposition? Could these decision aids reveal risks you might otherwise miss?
