By Chad Kessler MD FACEP FAAEM
Visitor editor Chad Kessler has assembled a professional panel of authors relating to changes of awareness. Articles comprise: The psychological prestige exam in Emergency perform, Dizzy and stressed: A step by step assessment of the Clinician’s favourite leader criticism, analysis and overview of Syncope within the Emergency division, The Emergency division method of Syncope: Evidence-based instructions and Prediction ideas, Pediatric Syncope: situations from the Emergency division, Seizures as a reason for Altered psychological prestige, significant worried process Infections as a reason behind an Altered psychological prestige? what's the Pathogen becoming on your imperative anxious System?, hectic changes in attention: tense mind damage, and extra!
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Extra resources for Alterations of Consciousness in the Emergency Department, An Issue of Emergency Medicine Clinics (The Clinics: Internal Medicine)
The cardinal difference between orthostatic and reflex-mediated syncope is that in orthostatic syncope, the autonomic nervous system attempts to control blood pressure with increased heart rate but fails, whereas in reflex-mediated syncope the autonomic nervous system acts inappropriately resulting in reflex bradycardia and vasodilation. Most causes of orthostatic syncope are benign. Orthostasis can be caused by medications such as antihypertensives, diuretics, and antidepressants. 12 Orthostatic syncope may also be caused by intravascular volume depletion such as in dehydration or blood loss.
Any patient who presents in a postictal state or with persistent neurologic symptoms did not, by definition, have a syncopal event. Patients who present with symptoms of near syncope should be treated as if they had syncope. Near syncope and true syncope are on a spectrum, with similar underlying causes resulting in decreased blood flow to the brain. Associated injury during a syncopal event Contrary to common belief, injuries suffered from syncope do not help in determining whether the inciting mechanism is dangerous or benign.
37. Gralnek IM, Barkun AN, Bardou M. Management of acute bleeding from a peptic ulcer. N Engl J Med 2008;359(9):928–37. lez C, Penado S, Llata L, et al. The clinical spectrum of retroperitoneal 38. Gonza hematoma in anticoagulated patients. Medicine (Baltimore) 2003;82(4):257–62. 39. Chan YC, Morales JP, Reidy JF, et al. Management of spontaneous and iatrogenic retroperitoneal haemorrhage: conservative management, endovascular intervention or open surgery? Int J Clin Pract 2008;62(10):1604–13.
Alterations of Consciousness in the Emergency Department, An Issue of Emergency Medicine Clinics (The Clinics: Internal Medicine) by Chad Kessler MD FACEP FAAEM