Syncope
Research
Program
CSRS Prehospital
Objectives
To prospectively validate and if needed refine the CPSRS for use by paramedics in the prehospital setting to accurately risk-stratify patients with syncope for any SAE occurring within 30 days.
Validate CPSRS on prehospital syncope patients, assess inter-observer agreement, and refine the score if needed.
Compare CPSRS to paramedic judgement and evaluate ED transport decisions.
Estimate patients avoidable for transport and identify missed SAEs at varying CPSRS thresholds.
Survey paramedic comfort post-study and follow-up with patients about non-ED decisions.
The Canadian Prehospital Syncope Risk Score may assist paramedics in identifying low-risk patients suitable for care outside the emergency department.
Eligibility Criteria
Only include each patient once to avoid double counting.
Inclusion Criteria
- Adults (age ≥ 18 years old)
- Suffer true syncope
- Access Paramedic services through 911 system
Exclusion Criteria
- Pediatric patients (<18 years old)
- Prolonged unconsciousness (>5 minutes)
- Change in mental status from baseline, witnessed seizure
- Loss of consciousness due to head trauma (i.e., trauma was the initial event)
- Unable to provide accurate details due to language barrier, cognitive impairment, alcohol, or drug intoxication
Data Collection
Prospectively collect data in the prehospital setting, and through records review in both prehospital and in-hospital settings.
Prehospital
- Electronic patient care records (ePCRs): paramedics will collect the CPSRS predictors prospectively during patient evaluation that are not routinely available in PCR or require paramedic judgement.
- Integrate predictors of CPSRS into the ePCRs to improve the ease of data collection. Otherwise, predictors will be collected through a separate data form through a link embedded within the ePCR.
- Collect defibrillator files for ECG retrieval which are obtained routinely by paramedics for patients with syncope as part of patient care.
In-Hospital
- Review in-hospital records (at receiving hospitals) both the index and return visits for investigations including outpatient testing performed and their results, any SAE identified, final ED diagnostic impression and ED disposition.
How can you help?
Patients with syncope call 911
Complete study form from ePCR
- Inclusion/Exclusion criteria
- Data for Canadian Prehospital Syncope Risk Score
- Your opinion and judgement of syncope patient
Obtain patient’s verbal consent and document on the study form
- For the use of medical data
- For 30-day telephone follow up
Obtain patient’s phone number/email address if consented
Syncope Image Resources
Syncope Video Resources
Explore educational videos covering various aspects of syncope evaluation and diagnosis.