Syncope

Who to Refer:

• Patient has had an unexplained blackout OR
• Patient has ongoing blackouts & further advice on management would be helpful

Who not to Refer:

• Patients with chest pain – refer to ED/Rapid Access Chest Pain Clinic/Cardiology as appropriate
• Patients with known cardiac disease that is likely to be the cause of their blackout – refer to cardiology
• Patients with palpitations – refer to cardiology
• Patients with likely seizure – refer to neurology
• Patients experiencing dizziness – see pathway below

How to Refer:

Via SCI Gateway for GP referrals

By copy of ED/Inpatient discharge letter for patients who have been seen in secondary care – see decision-aid below

For advice please email: DeptMedicine.Elderly@borders.scot.nhs.uk

If patient has had a blackout please give advice regarding driving as per DVLA guidelines prior to referral (see below).

Please send an ECG, outcome of clinical examination and (where possible) results of an active stand with the referral.

All referrals undergo Advanced Clinical Referral Triage (ACRT) and you may be asked to supply further information or a referral may be redirected to another service if this is felt to be more appropriate to the patient's needs.

We do not have access to AHP services through this clinic - if physiotherapy and/or occupational therapy assessment required please refer for this separately and at the same time as referral to clinic.

Patients may initially be offered a telephone appointment with further assessment (including face-to-face review if necessary) and investigations arranged thereafter. Please make it clear in the referral if there are cognitive or sensory issues that may make telephone assessment particularly difficult for patients.

Resources for professionals

DVLA Fitness to Drive Assessment - Guidance for medical professionals

Active Stand Proforma  Active stand.pdf

ED/MAU Syncope Decision Aid  ED MAU syncope decision aid.pdf

NHS Borders Dizziness Pathway  NHS Borders Dizziness Pathway.pdf

Patient information leaflets

DVLA Patient Information Leaflet  - Leaflet giving advice to patients who have been told to stop driving and inform the DVLA following a blackout. Blackouts DVLA patient info.pdf

Dropping Blood Pressure Patient Information Leaflet  - Patient information leaflet with self-management advice for patients suffering from postural, orthostatic, hypotension. Dropping Blood Pressure leaflet.pdf

Vaso-Vagal Syncope Leaflet fainting leaflet.pdf

DeptMedicine.Elderly@borders.scot.nhs.uk