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Emergency Medical Minute


Jul 22, 2019

Contributor: Don Stader, MD

Educational Pearls:

  • Syncope is usually benign but can be caused by serious etiologies which include: PE, certain cardiac arrhythmias, AAA, intracranial bleed/stroke
  • The Canadian Syncope Rule appears to identify those patients with syncope and low risk of serious outcomes
  • The score is based on vital signs, EKG and history
  • Negative scores preclude a very low risk of adverse events
  • A calculated score greater than 1 are considered medium risk
  • Scores greater than 4 are high risk
  • Anyone with a medium risk or higher should have their cause thoroughly investigated - which may involve admission or a shared decision making utilizing this rule if discharged

Editor’s note: just remember this rule has not been externally validated… yet


Thiruganasambandamoorthy V, Kwong K, Wells GA, et al. Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope. CMAJ. 2016;188(12):E289–E298. doi:10.1503/cmaj.151469


Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD