Transient loss of consciousness ('blackouts') in over 16s

National Institute for Health and Care Excellence


Initial assessment and diagnosis

  • See algorithm below

Advice to give when a person presents with transient loss of consciousness (TLoC)

  • Driving
    • give advice about eligibility to drive. Please refer to the DVLA for further information
  • Health and safety at work
    • advise people of the implications of their episode for health and safety at work and any action they must take to ensure the safety of themselves and other people

Red flags

  • Refer within 24 hours for specialist cardiovascular assessment (by the most appropriate local service) anyone with TLoC who also has any of the following
    • an ECG abnormality
    • heart failure (history or physical signs)
    • TLoC during exertion
    • family history of sudden cardiac death in people aged younger than 40 years and/or and inherited cardiac condition
    • new or unexplained breathlessness a heart murmur
  • Consider referring within 24 hours anyone aged older than 65 years who has experienced TLoC without prodromal symptoms

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