The authors further discuss how presyncope and syncope are poor prognostic indicators in patients with pulmonary embolus(PE). CORRESPONDENCE Response:Impactofaspecialistserviceinthe emergencydepartmentonadmission,lengthofstay andreadmissionofpatientspresentingwithfalls, syncopeanddizziness K.Jusmanova 1,C.Rice 1,2,R.Bourke 1,A.Lavan 1,G.McMahon 3, C.Cunningham 1,2,R.A.Kenny 1,2 andR.Briggs 1,2 From the 1 Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland, 2 Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland and 3 Department of Emergency Medicine, StJames'sHospital,Dublin,Ireland AddresscorrespondencetoRobertBriggs,Mercer'sInstituteforSuccessfulAgeing,StJames'sHospital,James'sSt,Dublin8,Ireland.email:briggsr@tcd.ie DearEditor, We thank Dr Kumari and Dr Mahla for their interest in our article regarding emergency department (ED) syncope management. [Extracted from the article]