Cardiology Emergency Medicine
ROSE Rule for Syncope
Risk Stratification of Syncope in the Emergency Department. Any criterion = high risk.
Score interpretation
Low Risk 0
No ROSE criterion: low risk of serious outcome or death at 1 month (rule NPV 98.5%).
→ Consider discharge. Outpatient cardiology follow-up as appropriate.
High Risk 1–7
≥ 1 ROSE criterion: high risk of serious outcome or all-cause death within 1 month.
→ Admit for monitoring. Cardiology review required.
Interpretation bands for the ROSE. Apply clinical judgement and local guidance.
References
- Reed MJ et al. The ROSE (Risk Stratification of Syncope in the Emergency Department) study. J Am Coll Cardiol. 2010;55(8):713-721.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Drugs
- Labetalol (IV — Hypertensive Emergency) · Combined Alpha-1 and Beta-Adrenergic Blocker
- Labetalol (IV — Hypertensive Emergency) · Combined alpha and beta blocker
- Tenecteplase · Cardiovascular Emergency
- Tirofiban · Cardiovascular Emergency
- Terlipressin · Gastrointestinal Emergency
- Octreotide · Gastrointestinal Emergency
Pathways
- 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
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.