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Pediatric syncope in the emergency department: a risk-stratified diagnostic and disposition pathway
Journal article   Open access   Peer reviewed

Pediatric syncope in the emergency department: a risk-stratified diagnostic and disposition pathway

Khaled Abouelmagd, Mariam Mohamed Mousa, Sohaila Mohamed Mohamed Abdelbar, Gabriela Berger, Sara Nalli, Alaa Mahmoud Zawrah, Kisa Fatima and Mohammed Alsabri
International journal of emergency medicine, v 19(1), 100
14 Apr 2026
PMID: 41975252
url
https://doi.org/10.1186/s12245-026-01215-zView
Published, Version of Record (VoR) Open

Abstract

Emergency Medicine Life Sciences & Biomedicine Science & Technology
Background Pediatric syncope accounts for 1-3% of emergency department (ED) visits. Although most cases are benign, 4% are caused by cardiac disease and 3% by seizures, which carry a risk of sudden death or neurologic injury if missed. Vasovagal syncope accounts for 52-74% of cases and postural orthostatic tachycardia syndrome (POTS) for approximately 13%. Objective To provide an emergency-department risk-stratified diagnostic and disposition framework for pediatric syncope. Key findings A universal 12-lead electrocardiogram (ECG) identifies nearly all life-threatening cardiac causes of syncope. When combined with structured red-flag screening and clinical risk stratification, patients can be reliably divided into low-, intermediate-, and high-risk groups, allowing safe discharge of benign cases and rapid admission of dangerous ones. Conclusion A standardized ED syncope pathway based on risk tiers and ECG-first evaluation improves patient safety while reducing unnecessary admissions and testing

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Emergency Medicine
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