Adult and Pediatric Telephone Triage Guidelines must be fast and easy to use. Because patients often present symptoms by site, titles are typically organized by anatomical site (and alphabetically) to facilitate locating the correct guideline! Forty-plus guidelines cover over 1,500 possible conditions!
Abdomen Problem:
1 (Upper & Generalized): Pain w or w/o Trauma;
2 (Lower): Pain w & w/o Trauma
Abuse: Sexual, Emotional, Physical, Financial
Back Problem (Upper & Lower): Pain w or w/o Trauma
Behavioral Problems:
Discipline: Temper Tantrums
Eating Problems: Food Allergies
Elimination Problems: Bedwetting (Enuresis); Soiling
(Encopresis); Toilet Training
Sleeping Problems: Bedtime Resistance; Early Morning Riser
Night Terrors; Nightmares
Bites (Skin Problem 1):
1 (Human/Animal): Human; Cat; Dog; Bat; Horse; Squirrel;
Skunk; Raccoon; Fox
2 Snake; Jellyfish; Sea Urchin; Stingray
3 Bee Stings, Yellow Jacket, Hornet, Wasp; Spiders; Scorpions;
Fleas; Ticks
Bowel Problem:
1 Diarrhea (Severe/Moderate/Mild); Incontinence; Bloody Stools
2 Constipation; Stool Color Change
Breast Problem:
1 Female (Non Pregnant, Non Post Partum): Pain w or w/o Trauma;
Discharge; Lump; Lesions
2 Male: Pain w or w/o Trauma; Discharge; Lump; Lesions
Breast feeding Problem: Pain w or w/o Fever; Sore Nipples; Painful Breasts
Burn (Skin Problem 2):
1 Thermal; Chemical; Electrical
2 Radiation (Sunburn)
Chest Pain: Pressure/Pain; w or w/o Trauma
Cold Exposure: Hypothermia; Frostbite
Confusion: Sudden; Chronic
Dizziness/Fainting: W or w/o Trauma
Ear Problem:
1 Pain w Trauma; FB; Hearing Loss; Ringing; Earlobe Trauma;
2 Pain w/o Trauma; Discharge; Congestion; Earlobe Swelling
Emotional Problem:
1 Suicide in Progress; Threat; Ideation
2 Panic; Depression; Anxiety; Agitation; Aggression;
Withdrawal; Hallucination
Extremities Problem:
(Upper): Pain w or w/o Trauma; Swelling; Lacerations;
Fractures
(Lower): 1 Pain w Trauma; Swelling; Lacerations; Fractures
(Lower): 2 Pain w/o Trauma; Swelling; Weakness; Limp
Eye Problem:
1 Pain w Trauma; Burn; FB; Vision Changes; Blood In
2 Pain w/o Trauma; Photophobia; Blood In; Discharge;
Swelling; Vision Changes
Face/Jaw: Pain w or w/o Trauma; Swelling; Weakness
Fever: High; Moderate; Mild
Head Problem:
1 Pain; Laceration; Level of Consciousness Change w Trauma
2 Pain; Level of Consciousness Change w/o TraumaHeat Exposure: Heat Stroke; Heat Exhaustion; Heat Cramps
Joint Problem (Upper & Lower):
Pain w or w/o Trauma; Swelling (Shoulder, Elbow, Wrist, Hip, Knee, Ankle, Foot); Limp
Lip/Mouth; Teeth/Gums; Tongue: Pain w or w/o Trauma; Swelling; Laceration; Lesions
Neck Problem: Pain w or w/o Trauma; Swelling; Lump
Newborn Concerns:
Behavior; Care; Bathing; Circumcision; Cord; Dressing; Skin Eyes; Elimination: Meconium Stools; Breast fed; Bottle-Fed); Urine Output Feeding Questions; Genitals; Head: Bruises; Fontanelle; Lumps; Molding Mouth; Nose: Coughing; Nasal Discharge; Sneezing; Skin/Rashes: Cradle Cap; Diaper Rash; Eczema; Erythema Toxicum; Heat Rash, Milia; Newborn Acne; Skin/Birthmarks
Nose/Sinus Problem: Pain w or w/o Trauma; FB; Bleeding; Discharge; Congestion
Pain Assessment
Penile/Scrotal/Testicle Problem: Trauma; FB; Pain; Discharge; Lumps; Lesions
Postpartum Problem:
Leg Pain; Painful Urination; Incisional Pain; Fever; Bleeding; SOB; Diarrhea; N/V; Abd. Pain
Pregnancy Problems:
1 Labor; Abdominal Pain; Vaginal Discharge; Vaginal Bleeding 2 Trauma; Headache; Chest Pain; Fetal Movement; N/V; Swelling; Burning on Urination; Itching
Rectal Problem:
Pain w or w/o Trauma; FB; Bleeding; Itching; Discharge; Lesion
Respiratory Problem:
1 Breathing Problem/Cough: Respiratory Distress; Choking; SOB; Stridor; w or w/o Trauma; 2 Throat: Choking; FB/Trauma; Pain; Burn: Chemical/Thermal
Seizures: W or w/o Trauma
Shock: Distributive; Cardiogenic; Hypovolemic
Skin Problem:
1 Bites: See Bites (Skin Problem 1) 2 Burn: See Burn (Skin Problem 2) 3 Discoloration: Bruise; Yellow; All Color Changes 4 Laceration/Wound: Amputations; Major and Minor Lacerations; Abrasions; Puncture Wounds 5 Lesion/Lump/Swelling: W or w/o Trauma 6 Rash: w or w/o Itching
Substance Abuse: Drug/Alcohol, Other Substances
Urinary Problem: Pain w or w/o Trauma; Frequency; Urgency; Discharge; Change in Output/Color; Bloody Urine
Vaginal Bleeding (Non Pregnant): Abnormal Bleeding: Painful, Irregular, Excessive; Absence of Menses
Vaginal Problem (Non Pregnant): FB; Trauma; Discharge; Pain; Lesion; Itching; STD Exposure
Vomiting/Nausea: Excessive; Bloody/Fecal; Food/Toxin; Dehydration
Women’s Health: Menopause Issues and Concerns, FAQ; Birth Control Issues and Concerns, FAQ
Telephone Triage Guidelines or Protocols: Supplemental Information
Adult Telephone Triage Guidelines or Protocols (Age 18+)
Pediatric Telephone Triage Guidelines or Protocols (School Age: 6 -18 Years)
Pediatric Telephone Triage Guidelines or Protocols (Infant-Child: Birth to 6 Years)
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