When should I worry?

Red Flag quick guide for Adults and Children

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.

Patients who present in practice or by telephone with the following symptoms seeking an appointment will not be given one in Primary Care – they will be advised to go to Urgent Care or A&E.

Symptoms

  • 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
  • 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.

If patient is saying they feel very unwell, please assess the following:

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