LOC associated with episode of abnormal breathing?
Associated with prodrome: dizziness, lightheadedness, nausea, sweating, weakness, changes in vision, fading of noises?
Concerning for hypoglycemia: known endocrinologic condition (e.g., diabetes)?
Requires hospital admission?
Counsel and treat as necessary.
Complete a full history and physical exam, including:
Concerning for anemia: heavy menstrual cycle, blood loss, history of anemia?
Cardiac Red Flags:
Concern for substance use or abuse?
Work up and treat hypoglycemia.
Check glucose and consider neuroimaging.
Consult Cardiology for further work up and management.
If recurrent episodes of syncope with strong personal or family history of migraines, can refer to Neurology for possible pharmacologic intervention.
Work up and treat anemia.
Concerning for migraine: headache, dizziness while seated, flashing lights, family history of migraine?
Provide appropriate counseling and referral to Obstetrics.
Focal neurologic symptoms, altered mental status, or significant head injury?
Concerning for seizure: prolonged loss of consciousness, post-ictal state, incontinence?
Breath-holding spells are benign. Reassurance and education should be provided to the family.
Key historical questions:
Reasons for hospital admission:
Work up and treat accordingly.