Zusammenfassung
Synkopen sind häufige Einsatzanlässe im Notarztdienst. Die Diagnosestellung ist meist
nicht schwierig, da dieses Krankheitsbild klar definiert und gegen andere Entitäten
abgegrenzt ist. Die häufigste Differenzialdiagnose ist der Krampfanfall, der durch
die Phase der Desorientierung gut von einer Synkope unterschieden werden kann. Die
Mehrzahl der Synkopen ist ungefährlich, in einigen Fällen liegen jedoch lebensgefährliche
Erkrankungen zugrunde. Diese Unterscheidung ist nicht immer einfach. Die mit Abstand
gefährlichsten Synkopen haben rhythmogene und andere kardiogene Ursachen. Die wichtigste
apparative Untersuchung ist das 12-Kanal-EKG, das so früh wie möglich geschrieben
werden sollte. Dem Notarzt kommt durch seine Feststellungen und Untersuchungen vor
Ort sowie durch die Bahnung des weiteren Patientenwegs eine Schlüsselrolle bei Synkopen
zu.
Abstract
Syncope is a common cause for EMS calls. Diagnosing syncope is easy in most cases
because this condition is well defined and can be separated from other illnesses.
The most common differential diagnosis is epileptical seizure. The distinction can
be made by a postictal period of disorientation which can't be found after syncope.
In most cases syncope is not dangerous but sometimes a life threatening condition
can be present. Recognising them can be difficult at times. Syncope by a rhythmogenic
or other cardiac origin is the most dangerous one by far. The single most important
diagnostic study is a 12-lead-EKG which should be obtained at the earliest time possible.
The findings and decisions by EMS physicians may be pivotal for the further course
of the patient.
Schlüsselwörter
Synkope - Notarztdienst - Risikostratifizierung
Keywords
syncope - Emergency Medical Service - risk stratification
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Dr. Thomas Fleischmann
Nordwest-Krankenhaus Sanderbusch
Interdisziplinäre Notaufnahme
Hauptstraße
26452 Sande
Email: t.fleischmann@sanderbusch.de