LAUSR

We aimed to determine the frequency of blood glucose and electrocardiogram (EKG) abnormalities in previously healthy children who present to an emergency department (ED) with a diagnosis of benign syncope. Chart review of consecutive children aged 5 to 18 years presenting to the pediatric ED from 2004 to 2014 with a discharge diagnosis of benign syncope was done. Of 969 patients, hypoglycemia (serum glucose <60 mg/dL) was present in only 3 cases (0.3%). Of 754 patients with EKG performed, only 4 cases (0.6%) was an abnormality requiring further cardiac evaluation identified; cardiac echocardiogram was performed in 3 of these 4 patients, which revealed no cardiac pathology. Financial analysis for performing blood glucose measurement and EKG on these patients amounted to total health care cost of $222 526. We concluded that previously healthy children with syncope rarely have hypoglycemia or underlying cardiac abnormality. The routine performance of tests can incur significant health care expenditure.