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Referrals

Syncope referral checklist

Baseline investigations, red flags, and referral note elements for syncope.

Last reviewed 2026-01-05|syncope | cardio | workup

Minimum pre-referral workup

  • Detailed event description, prodrome, and recovery.
  • Orthostatic vital signs and cardiovascular exam.
  • Resting ECG with interpretation.
  • Review medications and recent changes.
  • Point-of-care glucose and basic labs if indicated.

Urgency tier

  • Syncope during exertion or while supine.
  • Chest pain, palpitations, or family history of sudden death.
  • Abnormal ECG or known structural heart disease.
  • Significant injury or prolonged altered consciousness.
  • Persistent neurologic deficits after the event.

Referral packet checklist

  • Circumstances, triggers, and witness account.
  • Orthostatic measurements and ECG findings.
  • Medication list, substance use, and comorbidities.
  • Prior episodes or known arrhythmias.
  • Any ED visits or investigations already completed.

Pre-referral optimization tasks

  • Address reversible contributors such as dehydration or medication effects where appropriate.
  • Provide safety advice on activity and driving restrictions per local guidance when needed.
  • Reinforce return precautions for recurrent syncope, chest pain, or new neurologic deficits.