Last reviewed
2026-02-07
Workflow pack
Palpitations triage workflow
Workflow for rapid palpitations risk framing with escalation cues for unstable or high-risk rhythm presentations.
Trust and governance
Use only within this workflow's defined scope and exclusions.
Clinical owner
Family Medicine Editorial Team
Risk tier
High
Review cadence
Every 3 months
Next due 2026-05-07
Review status
Current
Scope limits
Initial outpatient palpitations assessment in clinically stable patients.
Exclusions (escalate/redirect)
- Hemodynamic instability or ongoing sustained unstable arrhythmia.
- Inpatient telemetry-based management scenarios.
References
Escalate-now emphasis (high-risk workflow)
If any red-flag item is present, stop routine workflow steps and activate emergency escalation immediately.
At a glance
Rapid decision framing for in-visit use. Educational only; always apply clinical judgment.
Immediate actions
- Check for associated syncope, chest pain, dyspnea, or poor perfusion symptoms.
- Document rhythm symptom pattern and potential triggers.
- Determine immediate escalation need before outpatient diagnostics.
Red flags / escalate now
- Palpitations with syncope, chest pain, hypotension, or severe dyspnea.
- Persistent rapid rhythm symptoms with instability signs.
- Rapid symptom progression in high-risk cardiac context.
First-line plan
- Stabilize reversible contributors and begin focused rhythm-risk workup.
- Use structured documentation for event pattern and associated red flags.
- Set early follow-up with clear escalation instructions.
Follow-up and monitoring
- Reassess quickly if episodes recur or intensify.
- Escalate urgently for new syncope, chest pain, or instability.
- Coordinate specialist review for unresolved high-risk patterns.
Next useful actions
Keep moving without restarting the search.
These are the most likely next clicks after opening this workflow.
Condition guidance
Referral checklists
Tools and calculators
Return precautions (patient script)
Suggested plain-language wording for safety-net counseling:
If symptoms get worse, new warning signs appear, or you cannot follow the plan from this visit, seek urgent care now.
- Use with the specific red flags listed on this page.
- Confirm follow-up timing and where to go after-hours.
- Document that return precautions were reviewed and understood.
Visit-close checklist
- Document disposition, rationale, and unresolved diagnostic uncertainty.
- Give explicit return precautions and follow-up timeline before ending visit.
- Attach a relevant handout when available to reinforce adherence and safety-netting.