The patient is simply extended consciousness

By creating a diagnosis unit specially intended for the study of cases of syncope arriving to its Emergency Department, hôpital de la Timone in Marseille, think have found a new source of productivity and streamlining of hospital support. "The loss of knowledge is ranked in the Top 10 of the most frequent symptoms received by the domain, but in the two third of the cases, the cause is benign", explains Dr. Eric Peyrouse, which coordinates this new unit. Prior to be sent home, the patient will have yet consumed a battery of examinations uncomfortable, expensive, time-consuming and "profitability of relatively low diagnosis." Each year, almost 200,000 persons "fell in apples" are thus hospitalized up to seven days, most of the time without reason.

The syncope diagnosis unit has been implemented in the cardiology department headed by Professor Deharo. It acts as a centre of expertise and ambulatory yard, where a medical team examines patients considered at risk. Upstream, the domain have been trained in a minimum balance of ten minutes to oust to at the outset the more mild cases.

As pain, syncope has long been considered a poor diagnosis parent. Its medical definition was also drafted in 2004, in a European publication: to be diagnosed as such, the loss of knowledge must be total (exit so the dizziness and other ailments), brief (it between if not on the territory of coma) and transient (the patient resumed knowledge of itself). From the physiological point of view, we know that the head is a sharp drop in cerebral blood flow which can have three causes.

The first is neurocardiogénique or vagal. This is the type of syncope, the most frequent, often due to fatigue, dehydration or emotion. In this case, the vagus nerve is taking action while it should not, which has implications for cardiovascular activity. Vessels dilate, voltage drop, the brain lacking oxygen, lost knowledge. The patient is simply extended consciousness.

In place in other countries

But the prognosis may be more serious. In a quarter of the cases approximately, syncope is cardiac: the rhythm of the heartbeat is jerky, the heart can sometimes take a break, tension playing the Yo-Yo and the brain is temporarily sous-oxygéné. Finally, in about 5 of diagnoses, can be of postural hypotension occurring at sunrise, especially among people with diabetes or neurological disorders: in this case, the cardiovascular system is unable to adapt quickly enough to the change of posture and the tension in the brain drops abruptly.

Syncope units already have their place in other countries, including in the United Kingdom, where they are located in the heart of the emergency services to accelerate the switch of patients, and Italy, in particular to the Rome hospital serving model in the creation of the marseillaise unit in the cardiology department. "The device has shown its effectiveness in both cases: more diagnostics, less exams, and a significant surge of emergencies", observes Eric Peyrouse. Not to mention the benefit for patients: in half the cases, they emerge today emergencies without a diagnosis has been established, anxious to re-offend.