The Role of the Emergency Medical System in the Assessment and Management of Syncope
Bibliographic record
Abstract
Syncope (Sync) and presyncope (presync) are common reasons for calling the Emergency Medical System (EMS). Usually, they are the first to arrive at the scene and to assist the patients. However, the information that they collect is not taking into account. The value of EMS findings for assessment and management of Sync has not yet been systematically evaluated. To analyze EMS findings and their contribution for Sync management Three blinded investigators systematically reviewed the electronic charts of all patients with syncope admitted to the Emergency Room (ER) at three academic hospitals from the Hamilton Health Sciences Corporation, (Hamilton General, Henderson, McMaster Medical Center), from January 1st to March 31st of 2004. EMS time to arrival to the scene and first assessment findings (brady or tachyarrhythmias, hypo or hypertension, level of consciousness) and their relationship with the final diagnosis were evaluated. A total of 23701 patients were seen in the ER during the screening period. Sync/presync was the primary diagnosis in 343 (1.44%): Sync 204 (59.4%) and Presync 139 (40.6%). 226 of this pts (66%) were assessed by EMS. The mean age was 69±22 years, 65% were female. EMS was able to detect significant findings in 56/226 pts (25%): bradycardia <50 bpm 6 pts (11%), tachycardia >100 bpm 18 pts (32%), hypotension <90/50 mmHg 18 pts (32%), hypertension >150/90 mmHg 21 pts (37%), loss of consciousness 4 pts (7%). Discharge ER diagnosis and percentage of vasovagal syncope are summarized in the following table: The average time for arriving to the scene was 7±5.8 minutes. Among the pts assessed by EMS who had a diagnosis of vasovagal syncope in ER, none of them were admitted. EMS assessment was associated with an increase (67%) in vasovagal diagnosis in community non-selected syncope pts. EMS findings also contributed to decrease unnecessary admissions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".