Syncope Decision Aid for Emergency Care

Setting:

Mount Sinai Hospital (MSH) has a 61-bed adult Emergency Department with a volume of over 100,000 patient visits/year or approximately 300 visits/day. MSH is a large academic tertiary care medical center located in East Harlem and serves a large black and Hispanic community.

Projected Recruitment: There are approximately 60 MSH ED visits for syncope per month of which 35 per month are by patients above age 30. Roughly half of these do not have a clear etiology of their syncope discovered in the ED. The researchers project that of the 17 potentially eligible patients per month, three will be successfully enrolled for a projected 72 patient enrollees at the completion of the 24-month recruitment period. The PI, clinical research coordinators, and SRAs will monitor the real-time electronic tracking system for all ED patients and will identify any patient over age 30 with a chief complaint of syncope or loss of consciousness.

Inclusion criteria

• Emergency Department patient
• Age 30 years or above
• Chief complaint of syncope
• Capacity to make medical decisions
• Speak and read English
• Working phone number and fixed address

Exclusion criteria

• Altered Mental Status
• Cognitive Impairment
• Serious acute diagnosis:

(e.g. clinically significant cardiac dysrhythmia, structural heart disease, gastrointestinal hemorrhage, myocardial infarction, pulmonary embolism, pneumonia, arterial dissection, serious infection, ectopic pregnancy, subarachnoid hemorrhage, or stroke.)

• Hemodynamic instability
• Inability to read or speak English
• Major communication barrier
• Lack of phone number or fixed address
• Too high risk as per physician judgment