CASE REPORT

2022/06/15
PGY2 余承祐
 GENERAL DATA
• Name: 曾 O 莎 • Systematic disease: denied
• Chart Number:5353292 • Food/ drug allergy:denied
• Age: 21 y/o • Alcohol drinking: nil
• Sex: female • Betel nut: nil
• First visit: 2020/12/11 • Cigarette-smoking: nil
CHIEF COMPLAINT
拔左上智齒
• post-op dizzy BP=127/86/74 1123, temp=37.0 頭低腳高
• con's alert BP=112/80/72 on 1140, SpO2=100%
• BP=115/78/66 on 1152 R/O anemia, R/O parasympathic
problem 建議急診 but she denied it
• BP=123/84/62 on 1208 F/U Explain Mother
 GENERAL DATA
• Name: 邱 O 瑋 • Systematic disease: denied
• Chart Number:5608162 • Food/ drug allergy:denied
• Age: 22 y/o • Alcohol drinking: nil
• Sex: male • Betel nut: nil
• First visit: 2021/04/14 • Cigarette-smoking: nil
CHIEF COMPLAINT
拔左上智齒
 GENERAL DATA
• Name: 莊 O 瑩 • Systematic disease: denied
• Chart Number:4205193 • Food/ drug allergy:denied
• Age: 29 y/o • Alcohol drinking: nil
• Sex: female • Betel nut: nil
• First visit: 2022/04/28 • Cigarette-smoking: nil
CHIEF COMPLAINT
拔左下智齒
• BP=112/79/66 on 1130
• BP=127/85/62 on 1145
 DISCUSSION

SYNCOPE
• Definition/ Classification
• Treatment
 DISCUSSION

SYNCOPE
• Definition/ Classification
• Treatment
 SYNCOPE

DEFINITION
• Syncope is defined as TLOC due to cerebral
hypoperfusion, characterized by a rapid onset,
short duration, and spontaneous complete recovery
SYNCOPE
 SYNCOPE

CLASSIFICATION
• Reflex syncope
• Syncope due to orthostatic hypotension
• Cardiac syncope
 SYNCOPE

REFLEX SYNCOPE
• Vasovagal
• Situational
• Carotid sinus syndrome
 SYNCOPE
SYNCOPE DUE TO ORTHOSTATIC
HYPOTENSION
• Drug-induced
• Volume depletion
• Primary/ secondary autonomic failure
 SYNCOPE
CARDIAC SYNCOPE
• Arrhythmia
• Bradycardia
• Tachycardia
• Structural cardiac
 VASOVAGAL SYNCOPE
Peripheral
Anxiet
Catecholamine ↑ vascular
y
resistance ↓
Bradycardi
a/ Decompensatio
Heart rate ↑
Nausea n
Breathing ↑
Lightheadedness
/ Seizure activity
Syncope
 VASOVAGAL SYNCOPE

Three distinct phases:

Prodromal phase
Loss of consciousness
Postsyncopal phase
 DISCUSSION

SYNCOPE
• Definition
• Treatment
 DISCUSSION

Treatment
• Supine position
• Stimulant
• Anxiolytic
 DISCUSSION

良好指標 高風險與高併發症指標
• 症狀緩解 / 消失 • 臉色蒼白、噁心
• 呼吸 / 意識正常 • 抽慉
• 未發生損傷 • 暈厥 / 意識喪失
 TREATMENT
前期徵象 疑似急症 終止當下醫療行為

暈厥發生 監測生命徵象 仰臥姿勢

安置病人
BLS 甦醒 終止治療，衛教
內科檢查
轉送急診
 THANK YOU
FOR LISTENING