/San Francisco Syncope Rule

San Francisco Syncope Rule

Predicts serious outcomes in syncope

Total Score

0

Low risk for serious outcomes. May consider discharge.

00Low
15High

Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.

Yasal Uyarı: Bu platformdaki klinik skorlamalar ve algoritmalar yalnızca sağlık profesyonellerini bilgilendirme amaçlıdır. Herhangi bir kesin tıbbi teşhis, tedavi veya klinik karar yerine geçemez. Nihai karar ve sorumluluk hastayı yatak başında değerlendiren hekime aittir.

Clinical Overview

The San Francisco Syncope Rule (SFSR) predicts short-term (7-day) serious adverse outcomes (MACE, pulmonary embolism, stroke, etc.) in patients presenting to the ED with syncope. Utilizing the CHESS criteria (CHF history, Hematocrit < 30%, ECG abnormalities, Systolic BP < 90, Shortness of breath), it helps determine safe discharge.

Clinical Pearl

While highly sensitive, its specificity is low. Use clinical judgment before admitting a young patient solely for a non-specific T-wave inversion. SFSR is best utilized as a 'discharge rule' rather than an 'admission rule'.

Pitfalls & Warnings

  • Ensure the event was true syncope and not a seizure, vertigo, or hypoglycemia before applying the rule.
  • The systolic BP criteria is based on the initial triage reading; subsequent normalization does not negate the risk.

Academic References

Quinn J, McDermott D, Stiell I, et al. Prospective validation of the San Francisco Syncope Rule to predict patients with serious outcomes. Ann Emerg Med. 2006;47(5):448-454.

Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.