Red Flags Flashcards
What are red flags?
alert signs and symptoms (“danger signs”) that indicate a more serious underlying pathology
Importance of red flags?
- life saving
- triage
- appropriate referral
Red flags for cough?
- Breathlessness at rest or while talking
- Respiratory rate >30 breaths per minute
- Prominent use of breathing muscles
- Coughing up >1 tbsp fresh blood
- Agitation or confusion
- BP <90/60
How is SOB a red flag?
- patient can become exhausted
- impending respiratory collapse
Note: sometimes SOB might be a baseline for example a severe COPD pt might not be a red flag
How is hemoptysis a red flag?
- Could portend serious blood loss (emergency!)
- Or be the sign of one of the more worrying causes of cough
Why is altered mental status a red flag?
This could represent impending inability to protect the airway!
Causes of altered mental status?
- Hypotension from shock?
- Acid/base imbalance from respiratory state?
Why hypotension is a red flag?
Shock: This patient could be undergoing circulatory collapse.
1. Septic shock: pneumonia?
2. Obstructive shock: pulmonary embolism?
3. Cardiogenic shock: acute CCF?
Red flags in abnormal vaginal bleeding?
- BP <90/60 or other signs of shock
- Pregnant?
- Recent abortion or miscarriage?
- Post menopausal
Signs of shock?
- tachycardia
- hypotension
- altered level of consciousness
- prolonged cap refill
- hyper or hypothermia
- Demonstrates concern for rapid bleeding which requires resuscitation and immediate intervention to stop bleeding
How abnormal vaginal bleeding is a red flag in pregnancy?
- Early in pregnancy <20 weeks → bleeding could be concerning for ECTOPIC, spontaneous abortion, gestational trophoblastic disease (molar pregnancy)
- Later in pregnancy >20 weeks → placenta previa, placental abruption, trauma, preterm labor
How abnormal vaginal bleeding is a red flag in recent abortion/miscarriage?
Bleeding following a miscarriage could be life threatening.
- Due to retained products of conception, atony, septic abortion.
How abnormal vaginal bleeding is a red flag in post menopausal women?
Concern for possible endometrial hyperplasia or carcinoma which should be investigated within 2 weeks
Red flags in abdominal pain?
- Rebound tenderness, guarding, rigidity
- Jaundice
- Temperature >38oC
- Failure to pass stool >24 hours
- Failure to pass flatus >24 hours
- Failure to pass urine >12 hours
- Pregnancy
- Chest pain
- Bilious emesis
- Trauma
- History of HIV – lactic acidosis
Red flags of lower back pain?
- Temperature >38oC
- Urinary incontinence
- Faecal incontinence
- Saddle anaesthesia
- History of cancer
- Unexplained weight loss
- Age <18 or >50
- History of HIV
- Urinary retention
- Recent trauma
- Use of corticosteroids
- Progressive motor weakness
- Severe pain with hematuria
Red flags in weight loss?
- History of cancer
- History of HIV
- Night sweats, fevers, hemoptysis
- Abnormal vaginal bleeding
Red flags in headache?
- sudden onset headache
- worsening pattern headache
- headache with systemic illness
- focal neurological signs or symptoms
- papiloedema
- headache triggered by cough exercise or Valsavas manoueuvre
- headache during pregnancy or post partum
- new headache with hx of cancer/HIV
- headache following trauma
- headache with jaw claudication
Red flags in GERD?
Red flags in red eye?
