Transient loss of consciousness--initial assessment, diagnosis, and specialist referral: summary of NICE guidance.

Initial assessment • At any stage, including initial presentation, if the person has sustained an injury or has not made a full recovery of consciousness, or if transient loss of consciousness is secondary to a condition that needs immediate action, use clinical judgment to determine appropriate management and the urgency of treatment. • Ask the person with suspected transient loss of consciousness, and any witnesses (try to contact these by phone if necessary), to describe what happened: -Before the event (circumstances, posture, prodromal symptoms) -During the event (appearance and colour; movement; any tongue biting or injury; and duration of transient loss of consciousness) -During the recovery period (confusion, weakness down one side). • Use this information to confirm whether transient loss of consciousness has occurred. When in doubt assume it has. • Assess and record: -Details of any previous transient loss of consciousness -Medical history and any family history of cardiac disease -Current medication -Vital signs -Lying and standing blood pressure if appropriate -Other cardiovascular and neurological signs.