Inclusion: Adult
Exclusion: Children or for patients whom episode of syncope is thought to be secondary to another disease process
Level A:
History and PE consistent with heart failure help identify patients at high risk for an adverse outcome.
Standard 12-lead ECG
Level B:
High risk of AE: Older age, structural heart disease, history of CAD
Low risk of AE: younger, nonexertional, with out history of or signs of CVD or family history of sudden death and with out co-morbidities
Admit patients with syncope and evidence of heart failure or structural heart disease
Admit patients with syncope and other factors that lead to stratification as high-risk for adverse outcomes.
Older age and associated co-morbidities
Abnormal ECG (Acute ischemia, dysrhythmia, or significant conduction abnormalities)
HCT < 30 (if obtained)
History or presence of heart failure, CAD< or structural heart disease
Level C:
Lab testing and advanced investigative testing such as echo or cranial CT need not be routinely performed unless guided by specific findings in the History and PE.
History and PE consistent with heart failure help identify patients at high risk for an adverse outcome.
Standard 12-lead ECG
High risk of AE: Older age, structural heart disease, history of CAD
Low risk of AE: younger, nonexertional, with out history of or signs of CVD or family history of sudden death and with out co-morbidities
Admit patients with syncope and evidence of heart failure or structural heart disease
Admit patients with syncope and other factors that lead to stratification as high-risk for adverse outcomes.
Older age and associated co-morbidities
Abnormal ECG (Acute ischemia, dysrhythmia, or significant conduction abnormalities)
HCT < 30 (if obtained)
History or presence of heart failure, CAD< or structural heart disease
Older age and associated co-morbidities
Abnormal ECG (Acute ischemia, dysrhythmia, or significant conduction abnormalities)
HCT < 30 (if obtained)
History or presence of heart failure, CAD< or structural heart disease
Lab testing and advanced investigative testing such as echo or cranial CT need not be routinely performed unless guided by specific findings in the History and PE.
ACEP clinical policies
Sign out tools
Reexamination sample documentation
Mass casualty incident triage
STOPP/START criteria
Denver screening criteria
Critical care documentation
Clinical decision rules list