San Francisco Syncope Rule (SFSR)

The San Francisco Syncope Rule (SFSR):

• Rule for assessing the risk of adverse events in patients who present with fainting or syncope.
• Remembered by the mnemonic CHESS.
• A patient with any of the features of CHESS is considered at high risk for a serious outcome.
• SFSR has a sensitivity of 74-98% & specificity of 56%.[1,2]
• Thus 74-98% of patients who have a serious outcome will have had a positive test.
• May be useful in ruling out hospital admissions for syncope patients presenting to the Emergency Department.

San Francisco Syncope Rule (SFSR) CHESS Mnemonic:

• C - Congestive heart failure history
• H - Haematocrit < 30%
• E - ECG Abnormal
• S - Shortness of breath
• S - Systolic blood pressure at Triage < 90 mm Hg 

References:
1 - Quinn J, McDermott D, Stiell I, Kohn M, Wells G (May 2006). "Prospective validation of the San Francisco Syncope Rule to predict patients with serious outcomes". Ann Emerg Med 47 (5): 448–54. doi:10.1016/j.annemergmed.2005.11.019. PMID 16631985.
2 - Birnbaum A, Esses D, Bijur P, Wollowitz A, Gallagher EJ (February 2008). "Failure to Validate the San Francisco Syncope Rule in an Independent Emergency Department Population". Ann Emerg Med 52 (2): 151–9. doi:10.1016/j.annemergmed.2007.12.007. PMID 18282636.


Tags: CCF - CHESS - Congestive Cardiac failure - Emergency Department - Fainting - Haematocrit - Mnemonic - San Francisco - San Francisco Syncope Rule - SOB - Syncope - Systolic BP - Triage
Posted by Medicalchemy
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