Syncope ECGs

Syncope is a sudden and transient loss of consciousness with loss of postural tone from which recovery is spontaneous and complete. An ECG is warranted on all patients to diagnose cardiac causes of syncope (A BRAIN CT OR MRI IS NOT NECESSARY)

EM Don’ts

  1. Avoid CT of the head in asymptomatic adult patients in the emergency department with syncope, insignificant trauma and a normal neurological evaluation.
  2. Avoid CT pulmonary angiography in emergency department patients with a low-pretest probability of pulmonary embolism and either a negative Pulmonary Embolism Rule-Out Criteria (PERC) or a negative D-dimer.
  3. Avoid lumbar spine imaging in the emergency department for adults with atraumatic back pain unless the patient has severe or progressive neurologic deficits or is suspected of having a serious underlying condition, such as vertebral infection or cancer with bony metastasis.
  4. Avoid prescribing antibiotics in the emergency department for uncomplicated sinusitis.
  5. Avoid ordering CT of the abdomen and pelvis in young otherwise health emergency department patients with known histories of ureterolithiasis presenting with symptoms consistent with uncomplicated kidney stones.