Boston Syncope Criteria
Identifies high-risk syncope features requiring hospital admission.
Score interpretation
No Boston high-risk features. Low risk. Consider discharge.
→ Discharge with appropriate follow-up.
≥1 Boston criterion present. Admission recommended.
→ Admit for monitoring, further evaluation, and specialist review.
Interpretation bands for the Boston Syncope. Apply clinical judgement and local guidance.
References
- Grossman SA et al. Derivation of the Boston Syncope Criteria to identify patients at high risk. J Emerg Med. 2007;33(2):131-139.
Related
Curated clinical cross-links plus same-class fallbacks.
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Hydroxocobalamin (High-Dose — Cyanide Antidote) · Cyanide Antidote (Vitamin B12 Precursor at High Dose)
- Lidocaine IV (Cardiac Arrhythmia) · Antiarrhythmic
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Mavacamten · Cardiac myosin inhibitor
- Thiamine (IV/IM — Pabrinex) · Vitamin B1 (Thiamine) — deficiency treatment / Wernicke's encephalopathy prevention
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
The Boston Syncope is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.