SPUC Clinical Advisor

Your Clinical Questions - Answered

You may feel confident in your pediatric urgent care knowledge base, but on a busy night, we all rely on the non-medical personnel who are greeting our patients as they walk through the door. 

Do your greeter and registration personnel know when to alert you that there may be a patient on site who can’t or shouldn’t wait to be seen?  The SPUC Clinical Advisor has an example of a “First Look” guideline and “Red Flag” list your non-medical staff can use for this reason.  Is it ok for a 5 week old with a chief complaint of fever to remain in the waiting room? What about a child who complains of difficulty breathing? 

The answers to your clinical questions can be found at http://www.urgentcarepeds.org/clinical/.

Here’s a look at our First Look/Red Flag List Clinical Advisor:

First Look and Red Flag List

A – Airway, Age of patient

  • Noisy breathing
  • Less than 6 weeks old
  • Allergic reaction

B – Breathing

  • Significant difficulty breathing for any reason

C – Circulation (blood)

  • Active bleeding for any reason (DO NOT REMOVE BANDAGES)

D – Disability (Trauma and neuro)

Injury

  • Neck injury
  • Chest and abdominal trauma
  • Fracture with obvious deformity
  • Fall in child less than 2 years old
  • Burns (any type)
  • MVA (motor vehicle accident) within 8 hours
  • Eye injury (any type)

Neurological

  • Active Seizure
  • Change in behavior for any reason
  • Loss of Consciousness

Pain

  • Testicular trauma or pain
  • Severe pain for any reason

Miscellaneous

  • Swallowed foreign object or medication
  • Known cancer patient or immune problem

RED FLAG LIST

If we are capping for the night, please call a nurse for the following in addition to the above list:

  • Asthma, wheezing, difficulty breathing
  • Fever and headache

Beyond Scope (Patients still require check in, but may need to be referred elsewhere)

  • Abscess needing incision and drainage
  • Complex Chronic Illness
  • Migraine Headache
  • Psychiatric problem

If you feel uncomfortable for any reason about a patient, call for a first look!

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