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all right so were gonna change gears a little bit and talk about syncope which to me is one of the most fun things in emergency medicine syncope is defined as a transient loss of consciousness followed by loss of postural tone or associate with the loss of postural tone with brief and spontaneous recovery so patients always learn and normal then loses tone falls to the ground unconscious generally the loss of consciousness to be very brief because theyre hypo proof using the brain and then they wake up on their own so if you have to give them the amp of d50 thats not considered syncope also it has to be a brief loss of consciousness so the patient is says yeah I passed out at 2 oclock in the morning and I woke up at 7 a.m. thats not syncope either thats Jack Daniels or a methadone all right so its actually funny and you can do a fantastically small workup that is completely based on the evidence the workup can be very very small but in the entire workup that you do you do a very