Syncope Breakdown
By definition, syncope is a transient loss of consciousness caused by a decrease in this specific bodily process.
What is cerebral perfusion (or blood flow to the brain)?
A seizure is characterized pathologically by excessive, hypersynchronous electrical activity in what types of cells?
What are neurons (brain cells)
Two dangerous, obsolete practices strictly prohibited during active convulsive seizures.
What are restraining movements and putting objects in the mouth?
Continuous convulsive seizure activity exceeding this critical time threshold defines status epilepticus and requires immediate high-priority ALS escalation.
What is 5 minutes
This simple point-of-care vital check must be obtained rapidly for both syncope and postictal seizure patients.
What is blood glucose check/level.
Appropriate BLS interventions when responding to someone who has suffered a syncopal episode.
What is administering low flow oxygen or glucose.
This seizure classification is distinguished by alternating whole-body stiffening followed by rhythmic jerking.
Position the patient in this position during and after seizure if there is no sign of trauma.
Recovery position (left lateral recumbent position)
This should always be considered a part of history of event when assessing syncopal or seizure patients, even if there is not direct evidence.
What is trauma
Two items needed to obtain a blood glucose level besides a glucometer, test strip, and gauze.
Emotional stress, severe pain, and prolonged standing trigger this common, nerve-mediated category of syncope.
What is vasovagal
The name of the recovery phase following a seizure where the patient may be delayed in returning to baseline neurological status`
What is a postictal state.
When obtaining a history for a seizure patient, it is helpful to use this mnemonic to obtain information.
What is FACTS. ("F" Focus, “A” Activity, “C” Color, “T” Time (onset and duration), “S” Supplemental History (medication compliance, trauma, last seizure)
These two interventions are a priority for a patient with a febrile seizure.
This level of blood glucose will prompt the EMT to consider administering oral glucose to the post-seizure/syncope patient.
Dehydration, acute blood loss, or certain medications most commonly lead to this postural cause of fainting.
What is orthostatic syncope (or orthostatic hypotension)
This non-epileptic acronym refers to seizure-like episodes with psychological origin rather than abnormal brain discharges.
It is important to record these two things in the PCR when responding to a seizure patient.
What are the blood glucose levels and the GCS at the time of blood glucose check.
These few conditions or symptoms in a seizure patient would indicate going "lights and sirens" to transport to ALS/HLOC.
What are an unmanageable airway, deteriorating vital signs or mental status, or persistent or recurrent seizures.
What is "milking" the finger.
Fainting can stem from vasovagal, orthostatic, or cardiac etiologies, but providers must also recognize that syncope can present secondary to these few other critical conditions.
What are seizure, hypoglycemia, stroke, intoxication, or trauma?
This diagnostic testing inpatient can monitor and track electrical activity in the brain.
What is an EEG (electroencephalogram).
A key distinction: syncope can sometimes produce brief myoclonic twitches, but a prolonged postictal state of confusion strongly points to this condition.
What is a seizure.
The class of rescue medications ALS providers carry (such as IV/IM Lorazepam or intranasal Diazepam/Valtoco) to terminate prolonged seizures.
What are benzodiazepines.
When IV access cannot be established or hypoglycemia persists, ALS units can administer this medication to mobilize liver glycogen stores, as referenced in the ALS intervention slides.
What is glucagon.