SW-RCT Implementation of Canadian Syncope Risk Score Based Practice Recommendations

Launched by OTTAWA HOSPITAL RESEARCH INSTITUTE · Jul 12, 2021

Keywords

ClinConnect Summary

The clinical trial titled "SW-RCT Implementation of Canadian Syncope Risk Score Based Practice Recommendations" is studying a tool called the Canadian Syncope Risk Score (CSRS) to help emergency department (ED) doctors make better decisions when patients come in after experiencing syncope, which is a temporary loss of consciousness. This trial aims to see if using the CSRS can reduce unnecessary hospital admissions and shorten the time patients spend in the ED, while still keeping them safe. By applying the CSRS recommendations, the researchers believe that only a small percentage of high-risk patients will need to be admitted to the hospital, and that many low-risk patients can be safely discharged more quickly.

To be eligible for this trial, adults over the age of 18 who come to the ED within 24 hours of experiencing syncope may participate. However, patients who have certain conditions or situations, such as a prolonged loss of consciousness or a clear seizure before the fainting episode, will not be included. Participants can expect that their care will be guided by the CSRS recommendations, which could lead to a more efficient and safer experience in the ED. This trial is currently recruiting participants and aims to involve several EDs across Canada to test how well the CSRS works in real-life settings.

Gender

ALL

Eligibility criteria

• Physicians:
• Inclusion criteria:
• • ED physicians involved in ED syncope care
• • Non-ED physicians involved in ED syncope care
• • Physician's delegates involved in ED syncope care
• Exclusion criteria:
• • ED physicians not involved in ED syncope care
• • Non-ED physicians not involved in ED syncope care
• • Physician's delegates not involved in ED syncope care
• Patients:
• Inclusion criteria:
• • Patients who are adults (aged \> 18 years)
• • Patients who present to the ED within 24 hours of syncope.
• Exclusion criteria:
• • Patients who do not fulfill the definition of syncope, namely those with a prolonged loss of consciousness (i.e., \> 5 minutes), Glasgow Coma Scale \< 15 in patients without dementia (or a change in the mental status from baseline in those with dementia);
• • Patients with witnessed obvious seizure, or head trauma preceding the loss of consciousness; and those who are unable to provide proper details (e.g., alcohol intoxication or other substance use).
• • Patients who had a serious underlying for the syncope identified during the index ED evaluation and those who were consulted to an inpatient service or hospitalized for reasons other than syncope workup (e.g., social reasons such as inability to cope at home, pain due to the fall, significant trauma).