Paediatric Syncope in the Emergency Department (DETECT-ED)
Syncope, Vasovagal, Postural Orthostatic Tachycardia Syndrome, Orthostatic Intolerance
About this trial
This is an interventional treatment trial for Syncope, Vasovagal
Eligibility Criteria
Inclusion Criteria:
- Those between the ages of 6-18 years (inclusive)
- Presenting to the ED daily 1000-2200 with resolved transient loss of consciousness that has occurred within the last week
- Able to complete the survey in English
- Willing and able to provide consent and assent
Exclusion Criteria:
Those with a known history of any of the following:
- Suspected or confirmed cardiac arrhythmia diagnosis (e.g., Wolff-Parkinson-White, long QT)
- Traumatic head injury
- New presentation of seizure disorder
- Epilepsy recurrence
- Overdose, intoxication
- Structural heart disease
- Patients with hypoglycaemia and who are psychogenic with vasovagal syncope who do not present with prodromal symptoms
- Previously enrolled in this study
Sites / Locations
- BC Children's HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Counterpressure Maneuvers
Usual Care
Participants will receive standard of care treatment (behavioural intervention and avoidance measures, as indicated in "Usual Care"), alongside training in counter pressure maneuvers. Training in counterpressure maneuvers will be delivered through a handout and video that will show three maneuvers (i.e. arm-tensing, squatting, and leg-crossing) that patients enrolled in the intervention arm can perform when they begin to experience common signs and symptoms of syncope. Patients will be instructed to start with one of the maneuvers and if their symptoms do not go away, move on to a second or third maneuver if needed.
Participants will receive standard of care treatment for their diagnosis of syncope. This primarily includes behavioural interventions and avoidance measures (e.g., stay hydrated, increase salt intake, avoid hot situations, avoid standing for long periods of time, engage in regular physical activity). Some patients may be prescribed medication (Midodrine, Fludrocortisone) at the discretion of their physician.