Sayk F, Frimmel M, Dodt C, Busch H-J, Wolfrum S
Sektion Interdisziplinäre Intensivmedizin, Sana-Kliniken Lübeck GmbH, Kronsforder Allee 71-73, 23560, Lübeck, Deutschland.
Interdisziplinäre Notaufnahme, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland.
Med Klin Intensivmed Notfmed. 2019 Jun;114(5):410-419. doi: 10.1007/s00063-018-0501-3. Epub 2018 Nov 9.
Transient loss of consciousness (TLoC) is a common complaint leading to presentation at the emergency department. This comprises a heterogeneous group of disorders including cerebral events, metabolic disturbances, intoxication, psychogenic patterns or any form of syncope. While many causes are benign and self-limited not requiring extensive in-hospital evaluation, others are potentially severe. The optimal evaluation of patients with TLoC/syncope follows a risk-adapted diagnostic algorithm in order to exclude life-threatening conditions and to identify those with high risk for further deterioration like structural heart diseases requiring further diagnostic evaluation. Low-risk patients can be discharged without further extensive diagnostic work up. This article presents an algorithm for structured, evidence-based care of the syncope patient in accordance with the recently launched "2018 ESC guidelines for the diagnosis and management of syncope" in order to ensure that patients requiring hospitalization are managed appropriately and those with benign causes are discharged safely. The English version of this algorithm is available at the end of the article under "Supplementary Material".
短暂性意识丧失（TLoC）是导致患者前往急诊科就诊的常见主诉。这是一组异质性疾病，包括脑部事件、代谢紊乱、中毒、心因性模式或任何形式的晕厥。虽然许多病因是良性且自限性的，无需在医院进行广泛评估，但其他病因可能较为严重。对短暂性意识丧失/晕厥患者进行最佳评估需遵循风险适应性诊断算法，以排除危及生命的情况，并识别那些有进一步恶化高风险的患者，如需要进一步诊断评估的结构性心脏病患者。低风险患者可在无需进一步广泛诊断检查的情况下出院。本文根据最近发布的《2018年欧洲心脏病学会晕厥诊断和管理指南》，提出了一种针对晕厥患者的结构化、循证护理算法，以确保需要住院治疗的患者得到妥善管理，病因良性的患者安全出院。该算法的英文版本可在文章末尾的“补充材料”中获取。
