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When do I go to the Emergency Department?

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The cause of a loss of consciousness can be so banal, like the fact of coughing energetically and blacking out, but it can also be a sign of a heart or circulation problem, and even a cerebrovascular accident (stroke); for this reason, someone, on their own, cannot determine the causes.

For this reason, although the loss of consciousness may have been temporary, it is advised to go an emergency department or a hospital, depending on the state of the patient and the circumstances.

When the loss of consciousness is longer, the patient should be taken to an emergency department as soon as possible, since the cause could be potentially serious.

There is a series of symptoms that can indicate if the loss of consciousness is due to a serious cause, such as:

Pain in the chest moments before the episode.

Palpitations, feeling the heart beating very rapidly or very slowly.

Intense headache.

Shortness of breath.

Patients of advanced age.

Repetition syncope.

Losses of consciousness making an effort.

In these cases, the patient should be taken to an emergency department as soon as possible.

There are patients that, due to the risks that they have, need an immediate assessment or even admission to hospital in the event of a syncope. It is particularly important in patients with a history of heart diseases, an infarction, or problems with heart valves, and in people that have a family history of sudden death.

Tests in the Emergency Room

When someone goes to the emergency department due to a loss of consciousness, the procedure is as follows:

The vital signs are taken.

Detailed clinical notes are made, as a well as a physical examination to rule out serious causes of the syncope, especially heart diseases.

An electrocardiogram is always performed to see if there are any changes that may help to establish the cause, such as an arrhythmia.

A capillary blood glucose is performed (finger prick to draw a drop of blood) in patients with diabetes who take oral anti-diabetics or insulin, in order to rule out hypoglycaemia.

If nothing abnormal is detected in this process, or if the patient does not have any heart disease or symptoms that may indicate seriousness, there is usually nothing else to do.

Other tests that can also be performed in order to determine the cause of the loss of consciousness are:

Blood tests.

A chest x-ray.

Measurement of oxygen in the blood.

The results of these tests will determine whether the patient can go home or has to be referred to a specialist, such as a cardiologist or neurologist, to finalise the diagnostic process and, if required, start immediate treatment.