San Francisco Syncope Rule (SFSR) ECG Findings Normal/Nonspecific Abnormal (New Changes) Paced Rhythm Hematocrit Critical threshold: <30% Blood Pressure CHF History Known congestive heart failure Shortness of Breath Present during episode Assess Risk Clinical Guidelines Sensitivity: 96% for serious outcomes Specificity: 62% (Reduces admissions by 10-20%) Serious Outcomes Include: Arrhythmia requiring intervention Myocardial infarction Pulmonary embolism Significant hemorrhage