Conditions
Syncope and presyncope triage
Office and urgent-care oriented syncope workflow emphasizing high-risk cause detection and safe disposition.
Last reviewed 2026-02-07|syncope | presyncope | triage
Assessment priorities
- Confirm true loss of consciousness versus near-syncope or seizure mimic.
- Assess trigger context, prodrome, recovery phase, and injury burden.
- Review cardiac history, medication effects, dehydration risk, and orthostatic findings.
Red flags
- Syncope during exertion, without prodrome, or with chest pain/palpitations.
- Persistent hypotension, abnormal rhythm concern, or neurologic deficits.
- Recurrent unexplained syncope with high-risk comorbidity.
Initial management
- Prioritize immediate hemodynamic and rhythm safety assessment.
- Use structured risk framing to choose urgent escalation versus monitored outpatient path.
- Document driving/work safety counseling where clinically applicable.
Follow-up and escalation
- Arrange prompt follow-up if outpatient pathway is selected.
- Escalate urgently for recurrent events, injury, or evolving cardiac/neurologic concerns.
- Coordinate specialist referral when high-risk etiology cannot be excluded.