You have been referred to the Falls and Syncope Service at the Royal Victoria Infirmary by your family doctor or another doctor or nurse involved in your care. We hope that reading this information will reduce any anxiety that you may have about coming for the appointment and also enable you to ask questions about your care when you come to see us. It will also help the doctors and nurses looking after you if you are well prepared and have brought all the important information we may need with you.
WHY DO I NEED THIS APPOINTMENT?
The majority of people we see in this department are referred because they are suffering from falls, dizziness and loss of consciousness. Some people complain of only one of these symptoms, while others may have more than one symptom. The medical term for loss of consciousness is syncope. The people referred to us can be of any age, but most are older adults. Your doctor has referred you for help with diagnosis and treatment of the problems you have been having. It may be that you have had a significant injury as the result of a fall or blackout, or that you have lost your confidence because you are frightened of falling or losing consciousness.
Please let us know if you are unable to attend, as we may be able to offer the appointment to another patient.
BEFORE YOUR TESTS
What will happen at the clinic?
In order to come to a diagnosis, the doctor will first need to take a careful history of your symptoms. Some details can seem quite trivial, but still provide important clues to the diagnosis. If you have suffered from loss of consciousness or near loss of consciousness, it is very helpful to have a description of the episode from someone who saw it.
We therefore ask that, if possible, you bring a relative, friend or carer with you who has seen an episode
If you live in a residential or nursing home, or are reading this leaflet on behalf of a resident, please note that this advice also applies to carers. It is much more helpful to us if the member of staff attending with the patient knows the patient and has witnessed an episode. The doctor will also ask you about your past medical history and whether any illnesses run in your family.
Do I need to bring anything with me?
It is very important to know if you are taking any medications.
Please bring your medications to the appointment, or an up to date list of medications and doses.
How should I travel to the clinic?
Please do not drive yourself to the clinic. This is because some of the tests we perform may make you feel dizzy and you may not be fit to drive home. In some cases you may be advised by the doctor that you should not drive until our investigations have been completed.
After taking the history, the doctor will examine you. You will be given a hospital gown for this examination but you will probably find it easier to change if you come in loose fitting casual clothing. If you wish to have a relative, friend or nurse with you when you are examined, please let us know.
DURING YOUR TESTS
What tests will I have?
During your appointment a nurse will perform some of the tests described below.
12 LEAD ECG
This is done by placing sticky ‘pads’ – electrodes – on the skin of the chest and limbs in order to record the electrical activity from the heart. It is used to check that your heart rhythm is normal, and whether there is any evidence of a previous heart attack.
You will be asked to lie on a bed while the nurse attaches a blood pressure monitor. A cuff will be put around your upper arm, similar to the cuff that your family doctor uses to take your blood pressure. A second cuff will be placed on your fingers. This is able to record the blood pressure with each heartbeat. You will be able to feel this cuff gently squeezing your finger. After resting for 10 minutes, the nurse will help you to stand up quickly. The equipment monitors the changes in your heart rate and blood pressure as you stand. If you do have a change in your blood pressure you may experience some symptoms of light-headedness or dizziness.
Please tell the doctor or nurse how you are feeling.
We will also need to take a blood sample from you. This will be taken by a nurse or a doctor.
We wish to make sure that you feel involved in your assessment and treatment. If you feel unhappy about any of the above procedures and do not wish to have a particular examination or test, please let the doctor or nurse know.
Data Protection Act
We will record information about your condition on an electronic database accessible only to members of staff in the department. This will enable us to send out follow up appointments and audit standards of care in the department. Some of the data may be used for research purposes, but if it is used in this way it will be anonymised and not traceable back to you. If you do not wish to have any data about your recorded on computer, please let us know. If you are happy with us recording this information, we will ask you to sign a disclaimer in your notes.
What happens next?
All of the information that we have collected about you will give us a clear idea about your condition. In some cases, further tests may be needed at another appointment. Please ask if you have any questions about further tests. After the first appointment and tests are completed, we will usually wish to see you again to find out how you are getting on. If you have any questions about your continued care, please do not hesitate to ask us
We hope that you have found this information helpful and look forward to meeting you when you come for your appointment
If you have any questions, please contact:
Falls and Syncope Service
Telephone 0191 282 5237
Hours Monday to Friday 9.00am – 5.00pm