New Referral Algorithms for Syncope and Dizziness

Seattle Children’s has created two new algorithms to assist community providers who are referring their patients with syncope or dizziness. Patients may be referred to Neurology, Cardiology or Otolaryngology depending on their symptoms.

Syncope

• Syncope decision tree (to schedule in Cardiology vs. Neurology)
• Refer to Neurosciences Center if the patient has syncope with tonic clonic movements, incontinence, postictal phase, altered awareness for more than three minutes or if the provider is specifically concerned about possible seizures or if there is a family history of epilepsy or seizures.
• Refer to Cardiology if the patient has syncope with exercise; when standing up or changing positions; with blackouts; or with palpitations, tachycardia or bradycardia.

Dizziness

• Dizziness decision tree (to schedule in Cardiology vs. Neurology vs. Otolaryngology)
• Refer to Neurosciences Center if the patient is dizzy with headache, altered vision, confusion or altered awareness.
• Refer to Cardiology if the patient has dizziness with tachycardia, palpitations when standing up, blackouts with syncope or concern for postural orthostatic tachycardia syndrome (POTS).
• Refer to Otolaryngology if the patient has dizziness with tinnitus, head movement, ear pain or fullness or change in hearing.