Danger elimination and treatment timescale for minor ailments Flashcards
Psoriasis
No previous diagnosis
Head lice
- treatment failure
- bacterial infection from scratching
Timescale for referral: ~2 weeks
Back ache
- medication failure
- severe back pain
- pins and needles radiating to upper leg
- middle/upper back pain
Timescale for referral: 5 days
Repetitive strain injuries
- suspected fracture
- medication failure
Timescale for referral: 5 days
Hair loss
- alopecia areata
- suspected drug-induced hair loss
- suspected hypothyroidism
- suspected anaemia
Timescale for referral: 6-12 months
Acne
- failed medication
- severe case
Timescale for referral: 8 weeks
Motion sickness
- glaucoma
- failed treatment
Colic
- failed medication
- suspected lactose intolerance (flatulence, vomiting, diarrhoea, spitting out milk)
- weight loss/failure to gain weight
Timescale for referral: 1 week
Athlete’s foot
- diabetes
- suspected bacterial infection
- affecting parts of foot other than in between toes
Timescale for referral: 2 weeks
Eczema and contact dermatitis
- broken skin
- signs of infection
Timescale for referral: 7 days/1 week
Mouth ulcers
- duration longer than 3 weeks
- ADRs
- Failed treatment
- ulcers greater than 1cm
- greater than 5-10 ulcers
- unexplained weight loss
- painless ulcers
- persistent diarrhoea
Nappy rash
- very severe rash
- other parts of body affected
- signs of bacterial infection
- OTC treatment failure
- broken skin
Timescale for referral: 1 week
Scabies
- babies and children
- bacterial infection
- treatment failure
Timescale for referral: 2 weeks
Warts and verrucae
- genital or facial warts
- itching/bleeding
- change in appearance of lesions (size/colour)
- diabetics
Timescale for referral: 3 months
Tension headaches and migraine
- children under 12 years
- severe and lasting >4hours
- associated with head injury/trauma
- nausea and vomiting
- ADRs
- severe occipital pain
- neck stiffness
- frequently recurring
timescale for referral: 1 day
Sprains and strains
- ADRs associated with falls/bruising
- suspected fracture
- medication failure
timescale for referral: 5 days
Dysmenorrhoea
- severe intermenstrual pain
- abnormal discharge or bleeding
- medication failure
- presence of fever
Timescale for referral: 2 menstrual cycles
Dandruff
- suspected psoriasis
- OTC treatment failure
- signs of bacterial infection
Timescale for referral: 12 weeks
Nausea and vomiting
- Children <2years
- blood in vomit/stool
- Lasting >48 hours in adults
Timescale for referral: >48 hours in adults
Common ear problems
- signs of infection (discharge)
- perforated ear drum
- pain
Timescale for referral: 1-2 weeks
Cold sores
- babies and children
- eye affected
- atopic eczema
- history of frequent cold sores
- painless sores
- signs of bacterial infection
Timescale for referral:
2 weeks
Oral thrush
- diabetes
- failed medication
- painless lesions
- recurrent infection
Timescale for referral: 1 week
Threadworms
- medication failure
- bacterial infection
- recent travel abroad
Timescale for referral: 2 weeks
Coughs
- long duration (2-3 weeks)
- difficulty breathing/shortness of breath
- coloured sputum (yellow/green/rusty/blood-stained)
- persistent nocturnal cough in children
- croup/whooping cough
Timescale for referral: 2 weeks
Sore throat
- long duration (2-3 weeks)
- ADRs
- unable to swallow
- white exudate on tonsils
- recurrent infection
Timescale for referral: 1 week
Irritable bowel syndrome
- child under 16 presenting for first time
- no previous history of IBS and no precipitating factors
- unexplained weight loss
- blood in stools
- failed treatment
- nausea
- vomiting
Timescale for referral: 1 week
Constipation
- blood in stools
- change in bowel habit lasting weeks or longer
- OTC medication failure
- ADR
- abdominal pain
- vomiting
Timescale for referral:
- 1 week with OTC treatment
- 2 weeks with dietary advice only
Colds and flu
- difficulty breathing
- wheezing
- persistent high temperature
Timescale for referral: 10-14 days
Insomnia
- suspected depression
- insomnia lasting >3 weeks
- children <16 years
- medication failure
Timescale for referral: 1 week
Conjunctivitis
- <2 years of age
- pain in eyeball
- recent eye surgery
- visual disturbance
Timescale for referral: 5 days
Vaginal thrush
- diabetes
- suspected pregnancy/pregnancy
- strong smelling/blood-stained discharge
- > 2 attacks in past 6 months
- OTC medication failure
- Under 16 years
- Over 60 years
- First occurrence
Timescale for referral: 1 week
Dyspepsia
- persistent symptoms >5 days
- ADRs
- Treatment failure
- Severe pain
- Severe pain that radiates to arm(s)
- Pain worsens on exertion/effort
- regurgitation
- difficulty swallowing
- blood in vomit/stools
- Over 45 years and first occurrence
- children
- unintentional weight loss
Timescale for referral: 1 week
Seasonal and perennial rhinitis
- failed medication
- wheezing/shortness of breath
- tightness of chest
Timescale for referral: 5 days
Diarrhoea
- Recent travel abroad
- blood/mucus in stools
- pregnancy
- suspected drug-induced reaction
- history of change in bowel habit
- lasting 1 day or longer in <1 year of age
- lasting 2 days or longer in <3 years of age or elderly
- lasting 3 days or longer in older children/adults
Timescale for referral:
1 day for children, 2 days otherwise
Cystitis
- blood in urine
- diabetes
- pregnancy
- failed medication
- all men and children
- loin pain/tenderness
- recurrent cystitis
Timescale for referral: 2 days
Haemorrhoids
- blood in stool
- persistent change in bowel habit
- duration longer than 3 weeks
- ADRs
Timescale for referral: 1 week
