Guidance
This guideline covers assessment, diagnosis and referral for people over 16 who have had a transient loss of consciousness (TLoC; also called a blackout). It aims to improve care for people with TLoC by specifying the most effective assessments and recommending when to refer to a specialist.
Recommendations
This guideline includes recommendations on:
- initial assessment
- further assessment and referral
- specialist cardiovascular assessment and diagnosis
- assessment when the cause of transient loss of consciousness is still uncertain
- information for people with transient loss of consciousness
Who is it for?
- Healthcare professionals
- Commissioners and providers
- People with suspected or diagnosed transient loss of consciousness and their families and carers
Is this guideline up to date?
February 2023: We will update the recommendations on measuring blood pressure in people with suspected orthostatic (postural) hypotension. For more information, see the surveillance decision.
Guideline development process
How we develop NICE guidelines
This guideline was previously called transient loss of consciousness (‘blackouts’) management in adults and young people.
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.