Last reviewed
2026-02-07
Workflow pack
Syncope/presyncope triage workflow
Risk-tiered syncope workflow emphasizing urgent cardiac/neurologic exclusion and safe outpatient follow-up.
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 evaluation of syncope and presyncope where immediate resuscitation is not required at triage.
Exclusions (escalate/redirect)
- Persistent unstable vitals or active emergency management situations.
- Complex inpatient syncope protocols requiring monitored admission workflows.
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
- Confirm event characteristics to distinguish syncope from mimics.
- Assess for cardiac, neurologic, and hemodynamic high-risk features.
- Establish whether disposition can remain outpatient safely.
Red flags / escalate now
- Exertional syncope, syncope with chest pain/palpitations, or abnormal perfusion.
- New focal neurologic deficits or persistent altered mentation.
- Recurrent unexplained episodes with injury or high-risk context.
First-line plan
- Use structured risk framing and targeted baseline workup.
- Provide safety counseling including activity/drive restrictions when indicated.
- Document escalation criteria clearly if outpatient pathway is chosen.
Follow-up and monitoring
- Arrange early reassessment for unresolved etiology.
- Escalate rapidly for recurrence, injury, or evolving instability.
- Coordinate specialist referral for high-risk or uncertain cases.
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.