Determining the Effectiveness of Counterpressure Maneuvers in Pediatric Patients Presenting With Syncope to the Emergency Department

What this Trial Is About

Researchers are studying the effectiveness of counterpressure maneuvers (CPM) to prevent fainting (syncope) in children and teenagers who visit the emergency department (ED) with fainting episodes. The study aims to better understand how syncope presents in pediatric patients and to evaluate whether CPM training can help reduce future fainting episodes. This research addresses gaps in knowledge about pediatric syncope, which is often assumed to be similar to adult syncope but may have different characteristics in children. The study has two stages. In stage I, pediatric patients aged 6 to 18 who recently experienced transient loss of consciousness will complete surveys about their fainting episodes and symptoms. In stage II, patients diagnosed with vasovagal syncope will be randomly assigned to receive either usual care (behavioral advice and avoidance measures) or usual care plus training in CPM such as leg crossing, arm tensing, and squatting. CPM training is provided via handouts and videos showing how to perform these maneuvers when feeling faint. Patients will be followed for one year, reporting monthly on any fainting or near-fainting episodes. Participants will complete surveys about their symptoms and fainting recurrences, and their medical records will be reviewed throughout the study. The main outcome is the number of patients who experience fainting again within one year. Secondary outcomes include typical symptoms before fainting, causes of syncope, and how well patients manage their symptoms with CPM or usual care. Researchers will monitor safety and compare results between the groups to understand if CPM training helps prevent fainting in pediatric patients.

Paediatric Syncope in the Emergency Department