This article originally appeared in the August 2021 SA国际传媒 Editor鈥檚 Picks newsletter. Click here to subscribe.
I鈥檝e been thinking and teaching lately about the diagnostic dilemma posed between syncope and seizure. These two presentations can be impossible to sort in the prehospital setting. As for syncope, my feeling is that emergency providers often pigeonhole all young folks who pass out very conveniently into the 鈥渧asovagal鈥� diagnostic category.
Here, I鈥檒l share some resources that are not directed toward standard textbook teaching.
In a recent , Nightscales, et. al., investigated the epidemiology and mortality in psychogenic, non-epileptic events. In my career, I know that I have certainly been guilty of underselling and underestimating these patients. This publication was a needed reminder that psychogenic non-epileptic seizure patients have significant morbidity and mortality, and
This presentation by Tarlan Hedayati, MD, is a reminder that patients can lose consciousness if their cardiac devices fail. Pacemaker pathology is often overwhelming, and this is
An ECG is vital in all patients who lose consciousness, no matter how young. , shared this photo from a patient who presented with a 鈥渟eizure.鈥� There is no 12-lead, just a monitor photo, which clearly demonstrates a Brugada pattern in V1. More information is needed, but this is an excellent reminder that we must view young syncope ECGs through non-ischemia lenses and not just comment on ST elevation.
In this ECG Case, shared by Robert Buttner and Emre Aslanger, a 24-year-old female presents who 鈥減assed out鈥� after alcohol ingestion. We see this presentation on every single shift. However, ; this patient is much more than 鈥渏ust intoxicated.鈥�
Shattering assumptions: 鈥楶seudoseizures鈥�
Kevin Crocker joins me in this episode of The MCHD Paramedic Podcast to discuss psychogenic seizures, a debilitating disease that needs more attention and improved treatment options. Listen to have your prior assumptions shattered, and leave a better and more empathetic provider.
Finally, unrelated to syncope and seizure, this recent , will hopefully make you step back a bit from all the current pandemic stressors and appreciate what a gift it is to be able to care for our patients.
