Pediatric syncope/presyncope (8 - 18 years) - Curbside

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Evidence
Total Notes: 2
Evidence

1 Syncope/Presyncope

Pediatric syncope is a common condition, up to 15% of children will have a least one episode of syncope during childnhood. Most cases of syncope are classified as autonomic (vasovagal, situational, or orthostatic in nature) with the remaining primarily represented by neurologic or cardiac causes. Life-threatening causes only represent 1-2% of all cases.



References:
  1. Chest pain and syncope in children: a practical approach to the diagnosis of cardiac disease.
    Friedman KG, Alexander ME,
    J. Pediatr. 2013 Sep;163(3):896-901.e1-3.
  2. Syncope in pediatric patients presenting to an emergency department.
    Massin MM, Bourguignont A, Coremans C, Comté L, Lepage P, Gérard P,
    J. Pediatr. 2004 Aug;145(2):223-8.
  3. Syncope in children and adolescents.
    Pratt JL, Fleisher GR,
    Pediatr Emerg Care 1989 Jun;5(2):80-2.
  4. Syncope in children and adolescents: a two-year experience at the Department of Paediatrics in Parma.
    Bo I, Carano N, Agnetti A, Tchana B, Allegri V, Sommi M, Squarcia U,
    Acta Biomed 2009 Apr;80(1):36-41.
  5. Syncope in the pediatric patient. The cardiologist's perspective.
    Lewis DA, Dhala A,
    Pediatr. Clin. North Am. 1999 Apr;46(2):205-19.
  6. Syncope.
    Kapoor WN,
    N. Engl. J. Med. 2000 Dec;343(25):1856-62.
  7. Implementing a guideline to improve management of syncope in the emergency department.
    Guse SE, Neuman MI, O'Brien M, Alexander ME, Berry M, Monuteaux MC, Fine AM,
    Pediatrics 2014 Nov;134(5):e1413-21.

2 History and physical

A detailed history and physical is nessessary in pediatric patients with syncope to ensure ellucidate the underlying cause of the event. The history should focus on high risk findings both in the past and surrounding the event.



References:
  1. Regional Implementation of a Pediatric Cardiology Syncope Algorithm Using Standardized Clinical Assessment and Management Plans (SCAMPS) Methodology.
    Paris Y, Toro-Salazar OH, Gauthier NS, Rotondo KM, Arnold L, Hamershock R, Saudek DE, Fulton DR, Renaud A, Alexander ME, Alexander ME,
    J Am Heart Assoc 2016 Feb;5(2)
  2. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
    Shen WK, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, Grubb BP, Hamdan MH, Krahn AD, Link MS, Olshansky B, Raj SR, Sandhu RK, Sorajja D, Sun BC, Yancy CW,
    Circulation 2017 Aug;136(5):e25-e59.
  3. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
    Shen WK, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, Grubb BP, Hamdan MH, Krahn AD, Link MS, Olshansky B, Raj SR, Sandhu RK, Sorajja D, Sun BC, Yancy CW,
    Circulation 2017 Aug;136(5):e60-e122.
  4. Syncope in the Pediatric Emergency Department - Can We Predict Cardiac Disease Based on History Alone?
    Hurst D, Hirsh DA, Oster ME, Ehrlich A, Campbell R, Mahle WT, Mallory M, Phelps H,
    J Emerg Med 2015 Jul;49(1):1-7.
  5. The diagnostic protocol in children and adolescents with syncope: a multi-centre prospective study.
    Zhang Q, Du J, Wang C, Du Z, Wang L, Tang C,
    Acta Paediatr. 2009 May;98(5):879-84.