Telephone Triage Protocols for Nurses
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This quick-reference manual presents over 200 triage protocols for evaluating patients' symptoms over the telephone. Each symptom entry lists questions, grouped by urgency level, to determine whether the caller should seek emergency care now, seek medical care the same day, call back for appointment, or follow home care instructions. Detailed home care instructions are then provided.This edition features fourteen new protocols: avian influenza; congestive heart failure; electrical burns; hand/wrist problems; hip pain/injury; influenza; neurological symptoms; newborn problems; pertussis; severe acute respiratory syndrome; sickle cell disease problems; substance abuse; West Nile virus; and wound care: sutures or staples. New appendices include difficult caller practice scenarios; acetaminophen and ibuprofen dosage charts; infant feeding guide; and causes and characteristics of abdominal pain, chest pain, and headache.
Introduction 1Abdominal Pain, Adult 4Abdominal Pain, Child 7Abdominal Swelling 10Abrasions 13Alcohol, Hangover 15Alcohol Withdrawal 17Allergic Reaction 19Altered Level of Consciousness 21Ankle Injury 24Ankle Problems 26Anxiety 29Appetite Loss, Adult 32Appetite Loss, Child 34Arm or Hand Problems 37Asthma 40Avian Influenza ("Bird Flu") 42Back/Neck Injury 45Back Pain 47Bad Breath 50Bed-Wetting 52Bee Stings 54Bites, Animal/Human 57Bites, Insect 60Bites, Marine Animal 64Bites, Snake 66Bites, Tick 68Black or Bloody Stools 70Bleeding, Severe 73Blood/Body Fluid Exposure 75Body Piercing Problems 77Bone, Joint, and Tissue Injury 80Breast-Feeding Problems 83Breast Problems 88Breathing Problems 90Bruising 93Burns, Chemical 95Burns, Electrical 98Burns, Thermal 101Car Sickness 104Cast/Splint Problems 106Chest Pain 108Chest Trauma 112Chickenpox 114Child Abuse 117Choking 119Choking Emergency Procedure 121Circumcision Care 128Common Cold Symptoms 130Confusion 133Congestion 136Congestive Heart Failure (CHF) 140Constipation 143Contact Lens Problems 146Cough 148Croup 151Crying, Excessive, In Infants 153Dehydration 155Depression 157Diabetes Problems 160Diaper Rash 163Diarrhea, Adult 165Diarrhea, Child 168Dizziness 172Domestic Abuse 175Drug and Alcohol Problems 177Earache, Drainage 180Ear Injury, Foreign Body 183Ear Ringing 185Electric Shock 187Extremity Injury 190Eye Injury 193Eye Problems 195Facial Pain 198Facial Skin Problems 200Fainting 202Falls 205Fatigue 208Feeding Tube Problems 211Fever, Adult 213Fever, Child 216Finger and Toe Problems 219Food Allergy 221Food Poisoning, Suspected 223Foot Problems 225Foreign Body, Eye 228Foreign Body, Inhaled 230Foreign Body, Nose 233Foreign Body, Rectum 235Foreign Body, Skin 237Foreign Body, Swallowing of 239Foreign Body, Vagina 241Frostbite 243Gas/Belching 245Gas/Flatulence 247Genital Lesions 249Genital Problems, Male 252Glands, Swollen or Tender 254Hair Loss 256Hand/Wrist Problems 258Hay Fever Problems 261Headache 264Head Injury 267Hearing Loss 270Heartbeat, Rapid 272Heartbeat, Slow 274Heartburn 276Heat Exhaustion 279Heat Stroke 281Hemorrhoids 283Hepatitis 285Hiccups 288Hip Pain/Injury 290Hives 292HIV Exposure 295Hoarseness 297Hospice Problems 299Hypertension 301Hyperventilation 304Hypotension 306Hypothermia 309Immunization After Injury 311Immunization Reactions 314Impetigo 316Incontinence, Stool 318Incontinence, Urine 320Indigestion 322Influenza 326Insomnia 329Intravenous Therapy Problems 331Itching 335Jaundice 337Jaw Pain 339Joint Pain/Swelling 342Knee Pain/Swelling/Injury 345Laceration 347Leg Pain/Swelling 350Lice 353Menstrual Problems 356Mouth Problems 359Mumps 362Muscle Cramps 364Nausea/Vomiting, Adult 366Nausea/Vomiting, Child 369Near Drowning 372Neck Pain 374Neurological Symptoms 377Newborn Problems 380Nosebleed 383Nose Injury 386Numbness and Tingling 389Ostomy Problems 392Overdose 395Pertussis 398Pink Eye 401Pinworms 404Poisoning, Suspected 406Postoperative Problems 409Postpartum Problems 412Pregnancy, Cold Symptoms 416Pregnancy, Fetal Movement Problems 419Pregnancy, Hypertension 422Pregnancy, Leaking Vaginal Fluid 425Pregnancy, Nausea and Vomiting 428Pregnancy Problems 431Pregnancy, Suspected Labor 435Pregnancy, Suspected Labor < 36 Weeks 438Pregnancy, Urination Problems 441Pregnancy, Vaginal Bleeding 443Puncture Wound 446Rash, Adult 449Rash, Child 453Rectal Problems 457Reye's Syndrome, Suspected 459Roseola 461Rubella (German Measles) 463Rubeola (Measles) 465Scabies 467Scrotal Problems 469Seizure 471Seizure, Febrile 473Severe Acute Respiratory Syndrome (SARS) 475Sexual Assault 478Sexually Transmitted Disease (STD) 480Shock, Suspected 482Shoulder Pain/Injury 484Sickle Cell Disease Problems 486Sinus Problems 489Skin Lesions 491Sleep Apnea, Adult 493Sleep Apnea, Infant 495Sore Throat 497Speaking Difficulty 500Spitting Up, Infant 503Stools, Abnormal 506Stye 509Substance Abuse, Use, or Exposure 511Suicide Attempt, Threat 514Sunburn 516Swallowing Difficulty 518Sweating, Excessive 520Swelling 523Teething 526Tongue Problems 528Toothache 530Tooth Injury 532Umbilical Cord Care 534Urinary Catheter/Nephrostomy Tube Problems 536Urination, Difficult 538Urination, Excessive 540Urination, Painful 542Urine, Abnormal Color 545Vaginal Bleeding 547Vaginal Discharge/Pain/Itching 550Vision Problems 552Weakness 555West Nile Virus 558Wheezing 561Wound Care: Sutures or Staples 564Wound Healing and Infection 567Abbreviations 570Sample Telephone Triage Protocol Form 571Community Resources Telephone List 573Telephone Triage Quality Improvement Survey 574Telephone Triage Documentation Form 575Telephone Triage "Call Back" Log 576Consulting Nurse Call Tape Review 577Consulting Nurse Call Documentation Review 578Telephone Triage Training Outline 579Guidelines for Scenario Practice 580Difficult Caller Practice Scenario 584Mystery Caller Practice Session 586Communicable Diseases 588Sexually Transmitted Diseases 593Typical Immunization Schedule 597Temperature Conversion Chart 598Weight Conversion Chart 599Acetaminophen Dosage Chart 600Ibuprofen Dosage Chart 601Infant Feeding Guide 602Teaching Self-Assessment 603Abdominal Pain Causes and Characteristics 605Chest Pain Causes and Characteristics 607Headache Causes and Characteristics 610Resources 612Bibliography 614Quick Reference Protocol Index 618
