Template:SF Syncope Calculator

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Interactive San Francisco Syncope Rule (CHESS) calculator. Requires the calculator gadget. Usage: {{SF Syncope Calculator}}

San Francisco Syncope Rule

San Francisco Syncope Rule (CHESS)
Criteria (CHESS) No Yes
C — History of CHF 1
HHematocrit <30% 1
E — Abnormal ECG (new changes or non-sinus rhythm) 1
SShortness of breath 1
SSystolic BP <90 mmHg at triage 1
Risk Factors / 5
Interpretation
0 Low risk — 2% risk of serious outcome at 30 days. Consider discharge with outpatient follow-up.
≥1 Not low risk — Cannot be classified as low risk. Consider further workup or admission.
References
  • Quinn JV, Stiell IG, McDermott DA, et al. Derivation of the San Francisco Syncope Rule. Ann Emerg Med. 2004;43(2):224-232. PMID 14747812.
  • Quinn JV, Stiell IG, McDermott DA, et al. The San Francisco Syncope Rule vs physician judgment and decision making. Am J Emerg Med. 2005;23:782-786.
  • Note: Sensitivity ~98% for serious outcomes. Some validation studies show lower performance. Use with clinical judgment.