History

Presenting pattern

Episode characterization

OPQRST

O onset

P provocation and palliation

Q quality

R region and radiation

S severity

T timing

Associated symptoms

Cardiopulmonary symptoms

Neurologic symptoms

Seizure suggestive features

Bleeding and volume loss features

Context and baseline

Baseline function

Comorbid context

Prior evaluations

Alarm Features

Immediate life threat triggers

Escalation triggers

High risk syncope features

High risk features

High risk ECG features

ECG red flags

Medications

Medication contributors

Syncope relevant medication classes

High risk interactions and contraindications

Treatment interaction traps

Diet

Volume and stimulants

Intake and hydration patterns

Stimulant exposures

Alcohol exposure

Review of Systems

Cardiopulmonary

Symptoms

Neurologic

Symptoms

Infectious and systemic

Symptoms

Bleeding and endocrine

Symptoms

Collateral History and Family History

Collateral details

Witness and collateral

Family history risk

Inherited and early cardiac disease

Risk Factors

Cardiac and arrhythmic risk

Cardiac risk factors

Arrhythmia risk factors

Thrombosis and bleeding risk

Thromboembolism risk

Bleeding risk

Special populations

Population modifiers

Differential Diagnosis

Life threatening

Life threatening causes

Common

Common causes

Less common

Less common causes

Mimics and pitfalls

Mimics

Past Medical History

Cardiovascular and neurologic

Relevant conditions

Procedures and devices

Implanted and procedural history

Physical Exam

General and vitals

General and vitals pattern

Orthostatic and hemodynamics

Orthostatic evaluation

Perfusion assessment

Cardiovascular

Cardiac exam

Pulmonary

Lung exam

Neurologic

Neurologic exam

Trauma and bleeding

Injury and bleeding evaluation

Lab Studies

Core ED tests

Baseline labs by risk and context

Targeted labs by differential

Differential driven labs

Pitfalls and limitations

Test limitations

Imaging

Scoring Systems

Risk stratification tools for syncope

MRI

MRI brain indications

MRI cautions and pitfalls

CT

CT head indications

CT chest and aorta indications

Ultrasound

POCUS applications

Ultrasound pitfalls

Special Tests

Bedside diagnostics

Bedside tests

Bedside interpretation pearls

Cardiac monitoring and device evaluation

Rhythm evaluation strategies

Device interrogation

ECG

ECG acquisition and red flags

ECG essentials

High risk ECG patterns

Serial ECG and monitoring

Serial evaluation logic

Assessment

Working diagnosis and risk tier

Syncope classification

Severity and complications

Complications and associated injuries

Diagnostic uncertainty

Plan

First 5 minutes and stabilization

Immediate priorities

Diagnostic sequencing

Stepwise diagnostic plan

Therapeutics

Targeted treatments by suspected cause

Reassessment loop

Reassessment cadence

Disposition impacting changes

Disposition

Level of care criteria

ICU or monitored unit criteria

Inpatient admission criteria

Observation pathway criteria

Discharge criteria and follow up

Discharge criteria

Follow up timing

Discharge Instructions

Copy discharge instructions

Summary

Hydration and triggers

Medications

Follow up

Return to the ED now for

References

Guidelines and decision tools

Core references

Project instructions source

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.