The following should be used as a guide by Patients and GP Reception Staff to identify when a patient should be sent straight to A&E or urgent care – and not wait to see a GP.
EYES: Sudden loss of vision, foreign body in the eye, trauma resulting in rapid swelling, any chemical injury – direct patient straight to A&E
MOUTH: Signs of anaphylaxis / allergic reaction – rapid lip and tongue swelling, wheezing, difficulty breathing – 999/ direct patient straight to A&E
THROAT: Any difficulty breathing, very noisy breathing, unable to swallow own saliva – direct patient straight to A&E EARS: Any bleeding from ear(s), any bruising behind the ear(s) – direct patient straight to A&E
CHEST / BREATHING: Any noisy breathing, struggling to speak in full sentences – 999/ direct patient straight to A&E
Child – any sucking under ribcage when breathing / very fast breathing – 999/ direct patient straight to A&E
HEART / CHEST PAIN: Any fast heartbeat that is making the patient feel unwell – 999 / direct patient straight to A&E Central crushing chest pain, radiating to left arm or jaw, associated with nausea and/or vomiting or sweating and feeling very unwell – 999 / direct patient straight to A&E.
SUSPECTED SEPSIS: If patient is saying they feel very unwell, please ask the following questions:
S: Shivering / hot / cold
E: Extreme pain or general discomfort
P: Pale or discoloured skin
S: Sleepy, difficulty waking and/or any confusion
I: Patient feeling very unwell ‘I feel like I might die’
S: Short of breath
ABDOMINAL PAIN: Patient says tummy feels very hard to touch and very painful. Patient complains of recurrent vomiting, high fever, and extreme abdominal pain, sweaty / clammy – 999 / direct patient straight to A&E.
NB: Any child with excessive thirst, excessive urinating, weight loss and / or lethargy must be offered an urgent on the day appointment. If they are drowsy or confused they must be redirected to 999 / sent straight to A&E.
Patients who present in practice or by telephone with these symptoms seeking an appointment will not be given one in Primary Care – they will be advised to go to Urgent Care or A&E.
For Worried Parents / Carers
A very useful guide has been produced for parents and carers of children, giving you advice about when to see the GP and how to treat many common childhood illnesses. The guide can be accessed using the following link. We recommend that parents and carers keep a copy handy with their first aid box.