Clinical Commander

SYMPTOM-LED (ED) · symptom.syncope.ed_undifferentiated· DEMO READY

Undifferentiated syncope. Rule out cardiac/vascular killers before attributing to reflex/orthostatic.

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Authored pathway active · symptom.syncope.ed_undifferentiated.ed

Undifferentiated syncope. Rule out cardiac/vascular killers before attributing to reflex/orthostatic.

8 must-ask3 must-not-miss

Guidelines: ACC/AHA/HRS 2017 Syncope Guideline · ESC 2018 Syncope Guideline · Canadian Syncope Risk Score (Thiruganasambandamoorthy, CMAJ 2020)

Phenotypes (4)

  • Syncope ED - Vasovagal (Reflex/Neurocardiogenic)
  • Syncope ED - Cardiac/Arrhythmic (High Risk)
  • Syncope ED - Structural Cardiac (AS/HCM/PE)
  • Syncope ED - Orthostatic Hypotension

Red flags (6)

  • Cardiac dysrhythmia (sustained VT, complete heart block, sinus arrest, long QT, Brugada, sustained SVT/AF with shock).CRITICAL
  • Structural heart disease (severe AS, HCM, tamponade, RV strain, acute MI, acute valvular failure).CRITICAL
  • Massive PE-induced syncope (sudden hypoxia + RV strain + hypotension; risk: malignancy, OCP, immobilization).CRITICAL
  • Ruptured AAA / aortic dissection (back/chest pain + syncope + pulse deficit + BP differential).CRITICAL
  • +2 more

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Uses LR engine cardio.syncope.v1, then routes suggested engines into the workspace.

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symptom.syncope.ed_undifferentiated · Emergency
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