Summary Loss of Consciousness History Taking Guide for Medical Students

Loss of Consciousness History Taking – Structured
Guide for Medical Students

1. Opening the Consultation
 Wash hands and wear PPE if needed.
 Introduce yourself (name, role).
 Confirm patient identity (name, DOB).
 Explain you want to take a history about the episode of LOC.
 Gain consent to proceed.


2. General Communication Skills
 Show empathy (respond to verbal/non-verbal cues).
 Use active listening (nod, eye contact, verbal affirmations).
 Maintain appropriate eye contact.
 Use open and relaxed body language.
 Avoid interrupting.
 Build rapport (e.g., ask how they’re feeling, offer a seat).
 Signpost throughout the consultation.
 Summarise regularly.


3. Presenting Complaint
 Start with open questions:
o “What brought you in today?”
o “Tell me about the episode.”
 Allow patient time to talk without interruption.
 Use prompts to expand:
o “Can you tell me more about that?”
o “What was it like?”


4. History of Presenting Complaint
A. Before the LOC
 Triggers:
o “Was there anything that triggered the episode?”
o Examples: emotional distress, standing up, coughing, shaving,
physical exertion, flickering lights.
 Prodromal symptoms (warning signs):
o Light-headedness, visual changes, sweating, nausea, tinnitus,
palpitations, chest pain.
o Ask: “Did you have any symptoms before passing out?”
 Aura/focal symptoms (suggest seizure):
o Strange smells/tastes, déjà-vu, visual or sensory changes,
twitching.