Syncope
Outpatients | Cardiology
This condition is treated in the Cardiology clinic.
Emergency Referral Criteria
If any of the following are present or suspected, please refer the patient to the Emergency Department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region. Clinical judgement should always be considered in addition to these criteria.
Criteria for Emergency include:
- Syncope with any of the following concerning features:
- exertional onset
- chest pain
- persistent hypotension (systolic BP less than 90mmHg)
- severe persistent headache
- focal neurological deficits
- preceded by or associated with palpitations
- known ischaemic heart disease or reduced LV systolic function
- associated with SVT or paroxysmal atrial fibrillation
- pre-excited QRS (delta waves) on ECG
- suspected malfunction of pacemaker or ICD
- absence of prodrome
- associated injury
- occurs while supine or sitting
- Seizures
If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.
Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.
Statewide Referral Criteria (SRC)
Criteria for referral to public hospital specialist clinic services
? Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.
Urgent (Category 1)
- New episode(s) of un-investigated syncope/near syncope without any of the listed Emergency Referral Criteria concerning features
Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review.
Semi-urgent (Category 2)
- Recurrent syncope previously investigated with undetermined cause
Routine (Category 3)
- No category 3 criteria
Information to be included in the referral
(Referral may be returned without this)
Essential supporting information
Pathology
- FBC
- UEC
- BSL
- TSH
- LFT
- CMP (Ca, Mg, PO4)
Imaging
- Any relevant - e.g. presence of impaired LV function by any imaging modality (MRI, Echo or MPS)
Investigations/other
- Lying/standing or sitting/standing BP
- Any relevant ECGs
Additional information
- Description of syncopal/pre-syncopal events including the following:
- timeline
- precipitating factors
- any warning pre-syncopal symptoms
- complete LOC or partial
- duration of LOC
- nature of recovery
- witnessed signs
- seizures
- pallor
- incontinence
- cyanosis
- irregular or absent pulse during attack
- associated injury
Interim/GP management
To refer a patient with this condition, please see the Cardiology clinic page for the full referral process and templates.
Interim management advice can be found at HealthPathways Tasmania.
For more information please see HealthPathways Tasmania