https://www.protriage.co.uk/training/video/course-introduction-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4790.mp4 Course Introduction Welcome to the ProTrainings Triage Online Course Course Overview This comprehensive course covers both telephone and face-to-face triage, following current protocols: Video-Based Learning: Watch a series of instructional videos. Knowledge Review: Answer review questions. Completion Test: Conclude with a short test to assess learning. Flexible Learning Key features of the course: Flexible Access: Start and stop the course at your convenience, picking up where you left off. Multi-Device Compatibility: View on any device—computer, smartphone, or tablet. Additional Support: Text supplements on each page and optional subtitles for enhanced understanding. Post-Course Benefits Upon successful completion: Downloadable Certificate: Print your completion certificate and other relevant materials. Resource Hub: Access additional training resources and links on the course homepage. Extended Access: Enjoy 8 months of access to the course content, even after passing the test. Support and Updates We provide: Free Company Dashboards: Contact us for information on tailored solutions for workplace training. Continuous Support: Full assistance throughout your training period. Stay Updated: Receive weekly emails with new course materials and blog updates. We hope you find this course enriching. Thank you for choosing ProTrainings. Good luck! https://d3imrogdy81qei.cloudfront.net/video_images/8527/Course_Introduction-01.jpg Yes 136 https://www.protriage.co.uk/training/video/meningitis- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4821.mp4 Meningitis Headache Assessment in Triage Introduction Hi, my name is Mark. I am one of the triage nurses today. Patient Assessment Patient Presentation: Brenda King, 14th June 1975 Chief Complaint: Severe headache, light sensitivity, vomiting Description of Symptoms: The headache is intense and widespread. Light causes significant discomfort. Duration of headache: Approximately two days. Accompanied symptoms: Nausea and vomiting. Medical Examination Initial Assessment: Confirmation of patient's identity and details. Blood pressure check and temperature assessment. Specific Symptoms: Patient reports pain at the back of the head. Light sensitivity confirmed. Stiff neck noted; painful on flexion. Further Inquiry: No history of head trauma or recent illness. No alcohol or drug use reported. First-time experience of such symptoms. Next Steps Medical Decision: High temperature and severe symptoms indicate immediate referral to A&E. Isolation precautions planned due to suspected infective process. Arrangements for a comfortable, low-light environment. Conclusion: We will get a wheelchair to take you straight to A&E for urgent evaluation and treatment. https://d3imrogdy81qei.cloudfront.net/video_images/8591/Meningitis-01.jpg Yes 180 https://www.protriage.co.uk/training/video/headache- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4818.mp4 Headache Headache Assessment and Triage Welcome to Triage Hi, I'm Mark, the triage nurse today. Let's quickly assess your condition to determine the best course of action for your care journey. Confirming Details Could you please confirm your name and date of birth? Brenda King, 15th June 1975. Assessment of Symptoms What has been happening, Brenda? Brenda describes a headache across her forehead persisting for a week. Details of Headache Pain Level: Rated 6/10, constant with fluctuations during the day. Associated Symptoms: No neck stiffness, no visual disturbances, no rash. Medical History and Current Condition Previous Occurrence: Similar episode a few months ago under stress. Current Condition: No recent trauma, no vomiting, no significant medical history. Allergies: None except occasional hay fever. Physical Examination Physical assessment findings: Neurological Exam: Normal strength, no sensory deficits. Cranial Nerves: Intact with normal responses. Next Steps Considering the persistent nature of your headache and family history of heart problems, we will arrange for a GP assessment and necessary tests. Thank you, Brenda. We'll get you the help you need promptly. End of Triage Assessment. https://d3imrogdy81qei.cloudfront.net/video_images/8601/Headache-01.jpg Yes 373 https://www.protriage.co.uk/training/video/vaginal-bleeding- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4822.mp4 Vaginal bleeding Assessment of Severe Bleeding: Triage and Immediate Care Introduction Hi. My name is Mark, and I am one of the triage nurses today. We'll quickly assess your condition and ensure you receive appropriate care promptly. Patient Details Name: Brenda King Date of Birth: 15th June 1975 Vital Signs Check Let's start with your vital signs. I'll check your blood pressure while we talk. Is that alright? Blood Pressure Arm: Left arm Temperature: Ear thermometer Chief Complaint Chief Complaint: Persistent and uncontrollable bleeding for three weeks Additional Symptoms: Passing large clots Changing clothes frequently (four times an hour) Feeling weak and dizzy Assessment Findings The bleeding is from the genital area, not the back. No significant pain reported, but extreme fatigue and dizziness noted. Medical Assessment: Low blood pressure and rapid pulse indicate urgent medical attention is required. Next Steps We need to get you to A&E immediately to see a doctor for further evaluation and treatment. Transport: You'll be taken in a wheelchair to A&E. Conclusion Thank you for your cooperation, Brenda. We'll ensure you receive prompt care and attention in A&E. https://d3imrogdy81qei.cloudfront.net/video_images/8597/Vaginal_bleeding-01.jpg Yes 184 https://www.protriage.co.uk/training/video/anaphylaxis- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4820.mp4 Anaphylaxis Allergic Reaction Triage Introduction Hello, I'm Mark, one of the triage nurses today. Could you please confirm your date of birth? Brenda King. 19th June '75. Symptoms and Assessment Brenda, what's been happening? Brenda: I had a takeaway about half an hour ago. Mark: Right. Brenda: And I just struggled to breathe. I don't know what I swallowed. Itchy all over. Mark: Okay, do you have any allergies? Brenda: Peanuts. Mark: Brenda, please open your mouth for me. Brenda: Okay. Mark: Have you got any pain where you are? Brenda: I just struggle to swallow. Immediate Action Mark: We need to get you moving straight away, Brenda. It looks like you're having an allergic reaction, okay? Brenda: Okay. Mark: Could we get the resus trolley around to triage, please? Quick. Quick. Immediately, thank you. Mark: Alright, Brenda, let's get you lying down. We'll get you on the couch. Brenda: Okay. Mark: They're coming in to move you now, okay? Brenda: Okay. Yeah. Mark: Oh, they're here. Great, okay. https://d3imrogdy81qei.cloudfront.net/video_images/8587/Anaphylaxis-01.jpg Yes 87 https://www.protriage.co.uk/training/video/ectopic-pregnancy https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4823.mp4 Ectopic pregnancy Triage Assessment for Abdominal Pain in Pregnancy Introduction Hi. My name is Mark, and I am one of the nurse practitioners here. We will be triaging you this morning to assess your condition. Confirmation of Details First, I need to confirm your details: Name: Brenda King Date of Birth: 14th June 1981 Vital Signs and Initial Assessment We need to check your vital signs, including your blood pressure. Let's do that while we talk, is that okay with you? Brenda: Yes, that's fine. Assessment of Pain Could you describe the pain you're experiencing? Location: Right side, with associated shoulder pain Character: Sharp stabbing pain Duration: Started two days ago Pain Severity: Rated as 20 out of 10 Medical History and Pregnancy Details Brenda: I'm about five weeks pregnant, our first child. History: No previous pregnancies or medical issues Medication: Folic acid, allergic to penicillin Next Steps Due to the severity of abdominal pain during pregnancy, especially on one side, we need to get you seen by a doctor in A&E promptly. Brenda: Okay, thank you. Conclusion We'll guide you to A&E now. Please follow the directions to the left, and we'll ensure you receive appropriate care as quickly as possible. Brenda: Thank you! https://d3imrogdy81qei.cloudfront.net/video_images/8603/Ectopic_pregnancy-01.jpg Yes 258 https://www.protriage.co.uk/training/video/debrief-headache https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4839.mp4 Debrief - Headache Assessment of Headaches and Red Flags Importance of Ruling Out Red Flags When assessing headaches, it's crucial to identify potential red flags that may indicate serious underlying conditions. Key Red Flags to Consider Photophobia: Test for sensitivity to bright light, as aversion can indicate certain neurological issues. Neck Stiffness: Assess if the patient can comfortably touch their chin to their chest, which helps rule out meningitis. Rash: Though rare, look for any skin rash which could suggest conditions like meningitis or temporal arteritis. Possible Causes of Headaches Headaches can be caused by various conditions including temporal arteritis, stress, or even stroke. Specific tests can help differentiate: Shining a light into the eyes to check for pupil reactions and equality. Performing the FAST test to assess facial drooping and limb weakness. Assessing for visual disturbances and any signs of neurological disability. Importance of Assessing Head Injuries For patients with recent head injuries, it's important to include trauma assessment, especially in older patients who may not recall a fall: Ask about recent falls or accidents involving the head, regardless of how long ago. Include head trauma evaluation as part of the headache assessment process. By carefully considering these factors, healthcare providers can ensure comprehensive assessment and appropriate management of headaches. https://d3imrogdy81qei.cloudfront.net/video_images/8613/Debrief_-_Headache-01.jpg Yes 100 https://www.protriage.co.uk/training/video/mental-health---potential-suicide https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4824.mp4 Mental health - Potential suicide Mental Health Crisis: Immediate Triage and Support Introduction Hi, I'm Mark, the triage nurse today. Could you please confirm your name and date of birth? Brenda King: 14th June '75 Assessment and Triage We need to conduct a quick assessment to ensure you get the right help. What brings you to A&E today? Reason for Visit: Feeling suicidal, took paracetamol an hour ago. Discussion When did these feelings start? Started about a month ago Have you experienced this before? No, first time experiencing this Substance Use: Took 50 paracetamol tablets and consumed one litre of lager Immediate Action Required We need to move quickly. Let's check your vital signs and get you to see a doctor: Check blood pressure Check temperature Support and Treatment We can provide immediate treatment to help you. Please come with me to A&E to see a doctor. Note: It's important that you came here for help. https://d3imrogdy81qei.cloudfront.net/video_images/8605/Mental_health_-_Potential_suicide-01.jpg Yes 279 https://www.protriage.co.uk/training/video/debrief-anaphylaxis https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4841.mp4 Debrief - Anaphylaxis Anaphylaxis Triage and Management Introduction This triage focused on anaphylaxis due to a peanut allergy. The patient consumed peanuts within the previous half an hour. Primary Assessment: Airway Protection Primary assessment in cases of anaphylaxis prioritises the airway. Any swelling in the airway requires immediate action: If there is swelling in the airway, the patient must return to resus immediately. The airway needs to be protected and established to prevent obstruction. Remember, swelling visible externally may also affect the mucous membranes internally, reinforcing the need to protect the airway comprehensively. Immediate Action for Anaphylaxis Anaphylaxis poses a serious threat to the airway, necessitating swift action: Move the patient to a place of safety. Initiate emergency protocols, including calling for a crash trolley. Commence treatment immediately to counteract the allergic reaction. Acting promptly can mitigate risks and improve patient outcomes in cases of severe allergic reactions like anaphylaxis. https://d3imrogdy81qei.cloudfront.net/video_images/8595/Debrief_-_Anaphylaxis-01.jpg Yes 56 https://www.protriage.co.uk/training/video/debrief-allergy https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4840.mp4 Debrief - Allergies Rash and Allergy Assessment Protocol Overview When assessing patients with a rash and suspected allergy, it's crucial to follow a systematic approach. Identifying the Rash and Allergy It appeared that this patient had an allergic reaction to fabric conditioner, resulting in a rash. Important Checks However, when evaluating a rash accompanied by itchiness: Airway: Always assess for any signs of airway compromise. Mucous Membranes: Check for any swelling or changes in the mouth and throat. Abdominal Pain: Inquire about any abdominal discomfort. Confusion: Assess for confusion, which can indicate a systemic reaction. Anaphylaxis: Rule out anaphylaxis, a severe allergic reaction. Next Steps Patients with straightforward rash symptoms can be referred to a GP at an urgent care centre for further evaluation to confirm or rule out serious allergic consequences. Patient Advice Ensure the patient understands: If symptoms worsen before their next medical appointment, they must: Alert Healthcare Provider: Notify healthcare providers immediately if there are changes in airway status, increased swelling, tongue swelling, or throat swelling. https://d3imrogdy81qei.cloudfront.net/video_images/8617/Debrief_-_Allergies-01.jpg Yes 62 https://www.protriage.co.uk/training/video/lower-back-pain---difficult-patient https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4831.mp4 Lower back pain - Difficult patient Managing Back Pain in Triage Introduction and Initial Assessment Hello, good morning. I'm Lutene, one of the triage nurses. We'll do a quick assessment and direct you to the right place. Confirmation of Details: Can you confirm your name and date of birth, please? Brendan King, 14th of June, 1960. Discussion on Symptoms Presenting Complaint: Brendan, what has brought you in today? Back pain. Duration and Changes: How long have you had this back pain? Years. Brendan mentioned it hurts more today than usual. Current Medication: Are you taking any painkillers for the back pain? Yes, Amitriptyline, co-codamol, and naproxen. Effectiveness: Are these medications helping? No, they don't do anything. Further Assessment and Plan Additional Symptoms: Any numbness or issues with urination? Brendan experiences pain down his right leg. Examination: Checking blood pressure and general condition. Pain Management: Brendan rates his pain at 10 out of 10. Next Steps Referral: We will get you seen by a GP in the urgent care centre. Direction: Head out of the department, left, then right towards the urgent care centre. Conclusion: Thank you, Brendan, for your cooperation. The GP will be waiting for you there. https://d3imrogdy81qei.cloudfront.net/video_images/8625/Lower_back_pain_-_Difficult_patient-01.jpg Yes 192 https://www.protriage.co.uk/training/video/mental-health---depression https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4826.mp4 Mental health - Depression Postnatal Depression Triage Assessment Introduction Hello, I'm Mark, the triage nurse today. Our goal here is to quickly assess your situation and direct you to the appropriate care. Patient Information Name and Date of Birth: Brenda King, 14th June 1984 Let's quickly check your blood pressure while we chat. Is that okay with you? Blood Pressure Check: Conducted Could you tell me what has been happening and why you're here today? Patient's Concerns Brenda expresses feeling overwhelmed and guilty despite having a new baby. Main Concerns: Feeling unable to cope Struggling with sleepless nights Feelings of not doing a good job as a mother Assessment Questions Have you felt suicidal or had thoughts of harming yourself? Suicidal Thoughts: Denied Support System: Brenda is currently alone with minimal family support. Next Steps Brenda, it's important to get you the help you need. We'll have you seen by a doctor in A&E who will assess your situation further. Plan: Direct Brenda to the A&E doctor for examination and support. Head left out of this room, follow the counter to the seating area near the TV displays. Please wait there. Thank you, Brenda. https://d3imrogdy81qei.cloudfront.net/video_images/8607/Mental_health_-_Depression-01.jpg Yes 266 https://www.protriage.co.uk/training/video/debrief-meningitis https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4842.mp4 Debrief - Meningitis Headache and Neck Stiffness: Potential Signs of Meningitis Introduction This patient presented with concerning symptoms related to a headache and neck stiffness. Symptoms and Assessment Chief Complaint: Headache of unknown cause Associated Symptoms: Neck stiffness Photophobia (aversion to bright lights) Diagnostic Consideration: If a patient presents with headache, neck stiffness, and photophobia, it can indicate potential signs of meningitis. Medical Evaluation Initial Assessment: Exclusion of trauma history Isolation due to suspected meningitis Monitoring of blood pressure and pulse for signs of compensation Temperature assessment to detect fever Types of Meningitis: There are various types including bacterial, viral, and fungal forms. Management and Isolation Immediate Action: Patient isolated in a dedicated room Urgent evaluation by A&E doctor Conclusion: Early recognition and isolation are critical in suspected cases of meningitis to prevent spread and ensure prompt treatment. https://d3imrogdy81qei.cloudfront.net/video_images/8631/Debrief_-_Meningitis-01.jpg Yes 79 https://www.protriage.co.uk/training/video/falls-vs-collapse https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4832.mp4 Falls vs collapse Triage Assessment for Arm Injury: Patient Care and Management Introduction to Triage Assessment Introduction: Hello, I'm Lutana, one of the triage nurses. Let's quickly assess your condition and direct you to the appropriate care. Patient Information Patient Details: Can you please confirm your date of birth and name? Brandon King. 14th of May, 1959. Assessment of the Injury Chief Complaint: Brandon reported passing out and injuring his hand. Details of the Incident: He tripped over a strip between the carpet and lino while moving from the living room to the kitchen. Medical History and Current Medication Medical History: Brandon takes blood pressure medication and uses medication for dizziness (possibly vertigo). Additional Information: No history of blood thinners or significant medical conditions. Clinical Examination and Management Physical Examination: Checked for arm mobility, sensation in fingers, and assessed pain level (rated 2 out of 10). Management: Applied a sling for support and removed a ring to prevent swelling. Conclusion and Next Steps Next Steps: Brandon will be referred to the minor injuries unit for further evaluation and treatment. Final Instructions: Exit through the double doors, turn left, then right to reach the minor injuries unit. Thank you for your cooperation, Brandon. We'll ensure you receive the appropriate care promptly. https://d3imrogdy81qei.cloudfront.net/video_images/8627/Falls_vs_collapse-01.jpg Yes 281 https://www.protriage.co.uk/training/video/debrief-heart-palpitations https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4834.mp4 Debrief - Heart palpitations Understanding Palpitations: Symptoms and Evaluation What are Palpitations? Palpitations are sensations felt inside or around the chest. Assessing Palpitations It's advisable to check the radial pulse to determine if it is regular or irregular. It's important to ascertain if palpitations are normal for the patient. Associated Symptoms Check for any pain or shortness of breath experienced alongside palpitations. Causes of Palpitations Palpitations may be attributed to anxiety, where it could be a sensation rather than an actual heart rhythm issue. However, palpitations could also indicate a serious cardiac arrhythmia. Immediate Evaluation If palpitations suggest a cardiac arrhythmia, prompt investigation with a heart tracing is necessary. https://d3imrogdy81qei.cloudfront.net/video_images/8757/Debrief_-_Heart_palpitations-01.jpg Yes 57 https://www.protriage.co.uk/training/video/debrief-chest-pain https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4838.mp4 Debrief - Chest pain Chest Pain Assessment and Red Flags Understanding Chest Pain Chest pain can indicate a range of conditions from musculoskeletal issues to serious cardiac or lung problems. Acting swiftly and assessing for red flags is crucial. Key Points to Assess Pulse: Check for regularity or irregularity. Nature of Pain: Determine what exacerbates or alleviates the pain. Additional Symptoms: Assess for shortness of breath, clamminess, sweating, and nausea. Identifying Serious Issues If there is suspicion of a cardiac issue: Immediate ECG (Electrocardiogram): A heart tracing should be performed urgently. Transfer to A&E: Move the patient to Accident and Emergency for further assessment. https://d3imrogdy81qei.cloudfront.net/video_images/8593/Debrief_-_Chest_pain-01.jpg Yes 55 https://www.protriage.co.uk/training/video/minor-arm-injury https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4830.mp4 Minor arm injury Triage Assessment for Shoulder Injury Patient Introduction Hi, I'm Mark, the triage nurse on duty today. Quick Identification Confirmation: Can I quickly confirm your name and date of birth, please? Patient Response: Brenda King, 1st July 1978. Initial Assessment Before proceeding further, let's check your blood pressure. Is this arm okay? Patient Comment: Aye, aye, steady, that's the bad arm, mate. Adjustment: Let's use the other arm instead. History and Incident Explanation: What happened to cause your injury? Patient Account: Fell down the stairs, missed the last two steps, landed on my left side. Further Inquiry Details: Any dizziness or breathing difficulties before the fall? Patient Response: No, none. Physical Examination Let's check your pulse and sensation without moving your arm. Evaluation: Can you feel me touching your fingers and thumb? Patient Feedback: Just a little numb, hurts around the hand. Pain Management Medication: Have you taken any pain relief? Patient Response: Paracetamol, about 20 minutes ago. Treatment Plan We'll place your arm in a sling for comfort. The pain relief should take effect shortly. Next Steps: You'll be seen at minor injuries to further assess your condition. Thank you for your patience. Let's get that sling on and ensure you're on your way. https://d3imrogdy81qei.cloudfront.net/video_images/8623/Minor_arm_injury-01.jpg Yes 199 https://www.protriage.co.uk/training/video/urine-retention https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4829.mp4 Urine retention Managing Urinary Retention in A&E: Triage and Assessment Introduction Good afternoon. I'm Lutena, one of the triage nurses. We'll be conducting a quick assessment to direct you to the appropriate care. First, could you please confirm your date of birth and name? Name: Brendon King Date of Birth: June 15th, 1960 Assessment of Symptoms Brendon, you mentioned you're unable to urinate. How long has this been an issue? Symptoms: Last urinated around 2am, minimal output Medical History: Prostate issue, taking Tamsulosin Current Condition Pain Level: Rated 8 out of 10; took co-codamol for back pain Vital Signs: Slightly elevated blood pressure and heart rate due to pain Additional Symptoms: Feeling full and distended Next Steps We'll proceed to A&E for a bladder scan to assess fluid retention and determine the appropriate treatment. Plan: Ensure comfort, conduct abdominal scan in A&E Conclusion Follow me down the corridor to the left. We'll get you scanned and start treatment promptly. Outcome: Swift diagnosis and treatment for urinary retention https://d3imrogdy81qei.cloudfront.net/video_images/8615/Urine_retention-01.jpg Yes 133 https://www.protriage.co.uk/training/video/abcde-and-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4869.mp4 ABCDE and triage Understanding the ABCDE System in Triage Overview of the ABCDE System Explaining the components of the ABCDE system used in triage: A - Airway: Ensuring the patient has a clear airway to breathe properly. This is critical in cases of throat swelling or choking. B - Breathing: Assessing if the patient can speak in full sentences and if their breathing is symmetrical and adequate. C - Circulation: Checking the pulse, skin colour, and overall perfusion to determine circulation status. D - Disability: Evaluating neurological function to understand the patient's awareness and responsiveness using scales like AVPU. E - Exposure: Examining the patient for any visible issues such as injuries or signs of distress. Importance of ABCDE in Triage Discussing the significance of the ABCDE assessment in triage: Constant Assessment: The ABCDE system is continuously in the triage nurse's mind, guiding the assessment process. Quick and Effective: It provides a rapid yet comprehensive method to evaluate and prioritize patient care needs. These ABCDE findings form the basis of critical decisions in triage, influencing patient management and pathway determination. https://d3imrogdy81qei.cloudfront.net/video_images/8691/ABCDE_and_triage-01.jpg Yes 156 https://www.protriage.co.uk/training/video/active-listening https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4870.mp4 Active listening Effective Telephone Triage Techniques Handling Information in Telephone Triage Addressing the challenges of gathering information over the phone in triage: Listening Skills: Given the absence of visual cues, active listening becomes crucial in telephone triage. Involving Third Parties: Sometimes involving a third party with patient consent can provide valuable insights, especially if the patient is unable to communicate effectively. Language Barriers: Overcoming language barriers by seeking assistance from interpreters ensures clear communication. It's essential to allow the caller to express their concerns fully without interruption to gather accurate information for informed decision-making. Techniques for Active Listening Strategies to ensure effective communication during telephone triage: Reassurance: Provide reassurance and empathy to help the caller feel heard and understood. Summarization: Summarize the information received to clarify and confirm understanding. Confirmation of Understanding: Ensure the caller understands the plan and is comfortable with it before concluding the call. These techniques enhance the quality of communication in telephone triage, facilitating accurate assessment and appropriate patient management. https://d3imrogdy81qei.cloudfront.net/video_images/8725/Active_listening-01.jpg Yes 155 https://www.protriage.co.uk/training/video/assessing-pain https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4874.mp4 Assessing pain Pain Assessment Techniques: Understanding and Application Objective vs. Subjective Pain Assessment Pain, a subjective sensation experienced by individuals, becomes objective when assessed by clinicians. Various pain assessment tools aid in this process, including the pain ladder and pain smiley faces. Pain Severity Scale: Typically measured on a scale of 0 to 10 Some variations: 0 to 3 or 0 to 5 Focus on Pain Quality: Triaging clinicians prioritize identifying the type of pain (sharp, dull, spasmodic, crampy) and its characteristics (radiation) over solely assessing severity. PQRST Mnemonic: P - Provocative and Palliative: What worsens or alleviates the pain? Q - Quality: Describing the nature of the pain (sharp, dull) R - Radiation: Any pain spreading to other areas? S - Severity: Numeric scale assessment T - Timing: When did the pain begin? Smiley Faces Technique: Originally designed for children but applicable to adults, this technique utilises smiley faces corresponding to numerical pain values (0 to 10). Patients select a face that best represents their pain level, aiding in accurate assessment. Conclusion Understanding and employing various pain assessment techniques, such as the PQRST mnemonic and smiley faces, enhances clinical evaluation, leading to effective pain management. https://d3imrogdy81qei.cloudfront.net/video_images/8719/Assessing_pain-01.jpg Yes 185 https://www.protriage.co.uk/training/video/hear-palpitations https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4771.mp4 Heart Palpitations Triage Assessment: Patient Consultation Example Introduction to Triage Assessment Hello, my name is Mark and I'm one of the triage nurses on duty tonight. Let's quickly assess your condition to determine the best course of action. Confirming Patient Details Could you please confirm your name and date of birth? Brenda: I am Brenda King, born on the 20th of January 1997. Mark: Excellent. What symptoms are you experiencing, Brenda? Brenda: Sometimes I feel my heart racing and occasionally it feels like it skips a beat. I'm quite concerned about it. Assessment of Symptoms Mark: How long has this been happening? Brenda: It's been on and off for about a month now. I can feel it beating fast right now. Mark: Have you had any shortness of breath? Brenda: No. Mark: Any chest pain? Brenda: No. Mark: Has this happened before? Brenda: About a year ago, but just once. Mark: And did you seek medical help then? Brenda: No, it was just a one-time thing. But now it's happening regularly. Physical Examination Mark: Let's start with checking your blood pressure first. Brenda: Okay. I'm not going to die, am I? Mark: No, we're just assessing you to determine the best care for you. Mark: Please relax your arm. (Procedure continues...) Discussion and Plan Mark: Your blood pressure looks good. We'll need to do a heart tracing to understand more about your symptoms. Brenda: Okay. Mark: You'll be moved to another area where a doctor will further assess you, possibly taking blood tests. Conclusion of Consultation Mark: If you leave this room and follow the counter around to the left, someone will conduct a heart tracing for you. Thank you. Brenda: Okay, thank you so much. Mark: You're welcome. Take care. https://d3imrogdy81qei.cloudfront.net/video_images/8503/Heart_Palpitations-01.jpg Yes 263 https://www.protriage.co.uk/training/video/debrief-lower-back-pain-difficult-patient https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4852.mp4 Debrief - Lower back pain - Difficult patient Managing Patient Care with Compassion in Triage Importance of Compassion and Empathy Compassionate Communication: It is crucial to show compassion and empathy towards patients, fostering open communication. Building Rapport: Establishing rapport helps patients feel comfortable sharing important details. Assessment and Patient Presentation Patient Presentation: The gentleman presented with long-standing back pain, dissatisfied with previous GP consultations. Managing Expectations: It is essential to manage patient expectations regarding treatment outcomes. Assessment for Red Flags: When assessing back pain, ruling out red flags such as cauda equina syndrome or trauma is crucial. Specific Questions Asked: I inquired about tenderness, numbness, and loss of bowel or urinary control, all of which were negative. Decision Making and Pain Assessment Urgent Care Setting: Considering the absence of trauma and stable symptoms, urgent care management was deemed appropriate. Pain Assessment: Despite the patient rating his pain as 10 out of 10, his presentation indicated comfort and no signs of distress. https://d3imrogdy81qei.cloudfront.net/video_images/8637/Debrief_-_Lower_back_pain_-_Difficult_patient-01.jpg Yes 125 https://www.protriage.co.uk/training/video/debrief-mental-health-potential-suicide- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4862.mp4 Debrief - Mental health - Potential suicide Mental Health Triage and Patient Safety Introduction This scenario involves a mental health triage assessment. Patient Assessment The patient had no prior history of mental health issues but expressed suicidal thoughts, which is a critical concern. Key Questions: Did the patient initially feel like harming themselves when taking an overdose? Do they still feel this way? These questions are challenging yet essential in assessing mental health crises. Handling Mental Health Patients Patients with mental health challenges require specific handling: They may need to be escorted to ensure their safety. Details like clothing, physical description, and other identifiers are noted in case of absconding. Treat all patients, including those with mental health issues, with respect and dignity. It's crucial to triage mental health patients equally and ensure they receive appropriate care. https://d3imrogdy81qei.cloudfront.net/video_images/8667/Debrief_-_Mental_health_-_Potential_suicide-01.jpg Yes 83 https://www.protriage.co.uk/training/video/documentation-and-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4879.mp4 Documentation and triage Importance of Documentation in Triage Process: Procedures and Security Overview of Documentation in Triage Explaining the significance and types of documentation used in the triage process: Digital Documentation: At our hospital, all triage records, including vital signs, are digitally recorded and stored in the patient's electronic health record for their lifetime. Variations Across Hospitals: Practices vary; some hospitals use fully digital systems integrated with IT, while others rely on handwritten records for the patient care journey. Special Cases: For mental health patients, specific pro forma documentation is used to record details like their condition and appearance, ensuring continuity of care and safety. Security and Confidentiality Addressing the importance of securing confidential patient information: Confidentiality Measures: All documentation is confidential and should be securely stored to prevent unauthorized access. Practical Security Practices: It's essential to lock screens and secure computers when not in use to safeguard patient data from breaches. Adhering to these documentation practices ensures accuracy, security, and confidentiality in patient care at all times. https://d3imrogdy81qei.cloudfront.net/video_images/8721/Documentation_and_triage-01.jpg Yes 137 https://www.protriage.co.uk/training/video/debrief-ectopic-pregnancy https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4844.mp4 Debrief - Ectopic pregnancy Ectopic Pregnancy: Symptoms and Emergency Considerations Overview Ectopic pregnancy is a serious condition that requires prompt medical attention. Symptoms of Ectopic Pregnancy Abdominal Pain: Typically one-sided lower abdominal pain, often in the iliac fossa. Referred Pain: Pain may radiate to the shoulder on the affected side. Pregnancy Status: Patient is pregnant; pregnancy needs to be confirmed. Immediate Action Required If ectopic pregnancy is suspected: Urgently move the patient to A&E for immediate assessment and treatment. Conditions to Consider Other conditions that may present similarly and need to be ruled out include: Appendicitis: Particularly if pain is on the right side. Peritonitis: Inflammation of the abdominal lining, which can cause widespread pain. Given the severity and potential complications, swift diagnosis and intervention are crucial. https://d3imrogdy81qei.cloudfront.net/video_images/8599/Debrief_-_Ectopic_pregnancy-01.jpg Yes 87 https://www.protriage.co.uk/training/video/analgesia-in-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4871.mp4 Analgesia in triage Options for Pain Relief in Triage: Tools and Techniques Overview of Pain Relief Options Exploring the tools and methods available for pain relief in triage: Patient Group Directive: Triage staff are trained to administer paracetamol or ibuprofen under this directive, streamlining pain relief without needing a prescription. Considerations: Before administering medication, it's crucial to assess risks such as previous medication use and existing health conditions like stomach ulcers. Importance of History Taking: Gathering detailed patient history helps in making informed decisions about appropriate pain relief. Advanced Pain Relief Options Options beyond basic medications available through triage: Intravenous Pain Relief: Patients may receive stronger medications like morphine via IV once they are on the appropriate care pathway. Pathway Prioritization: Initiating the correct pathway ensures timely access to more potent pain relief options as needed. Alternative Pain Management Techniques Non-medication strategies to alleviate pain: Positional and Comfort Measures: Techniques such as using arm slings for fractures or elevating limbs can provide significant relief. Psychological Support: Reassurance and supportive communication can have a placebo effect, positively impacting patient comfort. These methods aim to address pain effectively while considering individual patient needs and conditions. https://d3imrogdy81qei.cloudfront.net/video_images/8717/Analgesia_in_triage-01.jpg Yes 172 https://www.protriage.co.uk/training/video/establishing-patient-history https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4881.mp4 Establishing patient history Establishing Patient History in Triage: Tips and Techniques Importance of Patient History Understanding how to effectively gather and assess patient history in a triage setting: Identifying Chronic Illnesses: Patients often present with known medical conditions that may worsen (acute-on-chronic). Focus on what has changed and why they are seeking care today. Relevance and Conciseness: Avoid delving too far into historical details that are not pertinent to the current visit. Concentrate on changes in symptoms and their relevance to the current complaint. Strategies for Effective History Taking Practical tips for maintaining focus and relevance during patient history assessment: Body Language Awareness: Use non-verbal cues to guide the conversation and keep it focused on the presenting issue. Active Triage Management: Maintain control of the triage process by steering the conversation towards relevant information without unnecessary diversions. Clear Communication: Emphasize the importance of concise and accurate information from the patient to facilitate efficient triage. By following these guidelines, healthcare professionals can ensure a thorough yet focused assessment of patient history, leading to appropriate triage decisions and efficient patient care. https://d3imrogdy81qei.cloudfront.net/video_images/8727/Establishing_patient_history-01.jpg Yes 199 https://www.protriage.co.uk/training/video/dental-problem https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4835.mp4 Dental problem Assessment of Facial Swelling and Dental Pain Introduction Welcome: Hi, I'm Mark, the triage nurse on duty tonight. Let's quickly confirm your details and assess your condition. Patient Assessment Name and Date of Birth: Could you confirm your name and date of birth for me? Name: Dave Smith Date of Birth: 16.05.64 Initial Assessment: This is a quick triage to determine the next steps for your care. Medical Examination Blood Pressure Check: Let's take your blood pressure while we discuss your symptoms. Facial Swelling: I notice swelling on the right side of your face. Let's proceed with your temperature. Discussion of Symptoms: You mentioned a broken tooth that has caused significant pain and swelling. Pain and Difficulty Eating: The pain is severe, making it difficult for you to chew solid food. Swelling Inside the Mouth: You feel tenderness and swelling around the broken tooth. General Health Check: Ensuring your swallowing and breathing are unaffected by the swelling. Conclusion and Next Steps Clear Airway: Your airway is clear, and there is no obstruction. Referral to GP: We will refer you to see the GP for a thorough examination and further treatment. Final Instructions: Please proceed to the GP's office for detailed assessment and management of your dental issue. https://d3imrogdy81qei.cloudfront.net/video_images/8629/Dental_problem-01.jpg Yes 137 https://www.protriage.co.uk/training/video/eye-injury https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4836.mp4 Eye injury Eye Injury Triage and Assessment Introduction Triage Nurse Introduction: Hello, I'm Mark, the triage nurse on duty tonight. Let's start by confirming your name and date of birth. Quick Assessment Process Purpose of Triage: This is a quick assessment to determine the next steps for your care. Medical Assessment Blood Pressure Check: Can we take your blood pressure while we discuss your symptoms? Chief Complaint: The patient reported an eye injury from metal sparks while grinding, experiencing significant pain and irritation. Details of Injury Incident Details: About half an hour ago, sparks flew into the patient's right eye while working without goggles, causing severe discomfort and watering. First Aid Attempt: The patient used an eye wash bottle but still feels as if there is debris causing discomfort. Medical Examination Eye Examination: I will examine your eye quickly here, but we'll need to refer you to A&E for a more detailed examination using a slit lamp to check for any scratches or foreign objects. Eye Inspection: Please open your eyelids so I can inspect the affected eye. Treatment Plan Immediate Treatment: I will apply a temporary dressing to your eye to protect it, and we will arrange for you to be seen in A&E promptly. Pain Relief: You will be given Paracetamol to help manage the pain. Conclusion Next Steps: Please proceed to minor injuries where they are expecting you. They will continue your assessment and provide further treatment. https://d3imrogdy81qei.cloudfront.net/video_images/8647/Eye_injury-01.jpg Yes 167 https://www.protriage.co.uk/training/video/poisoning- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4837.mp4 Poisoning Triage Assessment for Beta-Blocker Overdose Introduction Introduction to Triage: Hi, my name is Mark. I'm the triage nurse today. Let's quickly confirm your details before proceeding. Patient Details Patient Details: Name: Barry Smith, Date of Birth: March 16, 1964. Triage Assessment Process Purpose of Triage: Triage involves a brief assessment to determine the appropriate care pathway. Blood Pressure Check: We'll check your blood pressure while we talk to ensure everything's okay. Patient History and Symptoms Medical History: Barry explains he's on beta-blockers and may have accidentally taken an extra dose due to stress. Symptoms: Barry feels lightheaded, dizzy, and experiences delayed cognitive response. Assessment and Evaluation Blood Pressure and Pulse: Barry's blood pressure and pulse are lower than usual, suggesting he may have taken an extra dose of beta-blockers. Medical History Review: Barry mentions previous heart issues and medication changes, noting today feels different. Next Steps Referral to A&E: Given the symptoms and potential overdose, Barry will be transferred to A&E for further evaluation and care under a doctor's supervision. Conclusion Final Instructions: Barry will be placed on a trolley and taken to A&E promptly to address his symptoms and ensure appropriate medical attention. https://d3imrogdy81qei.cloudfront.net/video_images/8651/Poisoning-01.jpg Yes 226 https://www.protriage.co.uk/training/video/unknown-condition---possible-stroke https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4846.mp4 Unknown condition - Possible stroke Neurological Symptoms Assessment in Triage Introduction Triage Nurse Introduction: Hi, I'm Mark, the triage nurse on duty tonight. Could you please confirm your name and date of birth for me? Patient Confirmation: Yes, it's Barry Davis and my date of birth is May 16, 1972. Triage Assessment Process Quick Assessment: Triage involves a rapid evaluation to determine the appropriate care pathway. Initial Checks: Let's start with your blood pressure, if that's okay with you? Neurological Symptoms: Patient reports strange sensations, including pins and needles and numbness on the left side of the face and tongue. Patient History and Symptoms Onset of Symptoms: Symptoms began this morning with weakness and sensory changes in the limbs and face. Additional Symptoms: Patient also complains of headache. Medical Examination Blood Pressure and Pulse: Blood pressure noted to be high, patient reports accompanying headache. Neurological Examination: Assessing pupil reactions, facial muscle strength, and limb mobility to identify any neurological deficits. Assessment Findings Neurological Deficits: Patient exhibits weakness on the left side of the body, consistent with reported symptoms. Next Steps Immediate Action: Patient to be transferred to A&E for further examination by a doctor. Pain Management: Pain relief to be administered after doctor's assessment. Transport: Patient will be moved promptly to A&E for thorough evaluation and treatment. https://d3imrogdy81qei.cloudfront.net/video_images/8661/Unknown_condition_-_Possible_stroke-01.jpg Yes 244 https://www.protriage.co.uk/training/video/diarrhoea-and-vomiting https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4847.mp4 Diarrhoea and Vomiting Assessment of Gastrointestinal Symptoms: Potential Dehydration Patient Presentation Introduction: Hi, I'm Mark, the triage nurse on duty tonight. Could you please confirm your name and date of birth? Patient Details: Yes, I'm Fred Yates, born on April 16, 1962. Triage Assessment Blood Pressure Check: Let's check your blood pressure while we talk to save time. Please use your left arm. Medical History: Patient returned from a recent cruise and has been experiencing severe symptoms for over a week. Presenting Symptoms Gastrointestinal Issues: Patient reports continuous vomiting of yellow bile, ongoing diarrhoea that's watery with mucus, and inability to retain fluids or food. General Condition: Symptoms include headache, lethargy, and overall malaise. Further Examination and Action Dehydration Assessment: Skin tenting observed, suggesting possible dehydration due to fluid loss. Plan: Immediate referral to A&E for evaluation and likely treatment of dehydration. Conclusion Next Steps: Patient will be provided with a wheelchair to facilitate transfer to A&E for prompt medical attention. Additional Information: No chest pain reported; rib pain attributed to frequent vomiting. https://d3imrogdy81qei.cloudfront.net/video_images/8663/Diarrhoea_and_Vomiting-01.jpg Yes 203 https://www.protriage.co.uk/training/video/debrief-abdominal-pain https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4848.mp4 Debrief - Abdominal pain Assessment of Abdominal Pain in Triage: Best Practices Understanding Abdominal Pain Assessing abdominal pain in triage can be challenging due to the numerous organs in the abdominal cavity. Specific Pain Localization When assessing pain location, it's crucial to ask patients to point with one finger to specify the exact site of discomfort. This method avoids vague descriptions using the whole hand. Gender-Specific Considerations Female patients may experience cardiac pain differently than males. It's essential to consider this difference unless the patient presents with a known medical history, such as gallstones, which can lead to typical gallstone pain. Diagnostic Considerations For patients suspected of having biliary colic, including this case, consideration of an ECG may be beneficial to rule out cardiac issues. Biliary colic is not solely related to gallstones; it also involves assessing their location and potential for infection. https://d3imrogdy81qei.cloudfront.net/video_images/8619/Debrief_-_Abdominal_pain-01.jpg Yes 79 https://www.protriage.co.uk/training/video/debrief-testicular-pain https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4849.mp4 Debrief - Testicular pain Managing Testicular Pain in A&E: Triage and Assessment Introduction The scenario involved a gentleman presenting to the A&E department with testicular pain. Testicular pain can present with various complexities, necessitating specific questions to rule out serious conditions. Key Triage Questions Duration of Pain: Asked about when the pain started, linked to activity Type of Pain: Described as throbbing and sudden onset upon standing Asymmetry: Checked for any difference in testicle height, ruling out testicular torsion Swelling or Trauma: Inquired about any swelling, injury, or signs of infection Vital Signs and Pain Assessment All vital signs were normal, though heart rate was slightly elevated due to pain Pain Score: Assessed to ensure patient comfort, already medicated prior to triage Importance of Prompt Action It is crucial for clinicians to promptly assess and rule out conditions like testicular torsion to prevent complications. Directing the patient to the appropriate department ensures timely and effective treatment. Given the high pain score and presentation, a full examination at triage was deemed unnecessary. https://d3imrogdy81qei.cloudfront.net/video_images/8621/Debrief_-_Testicular_pain-01.jpg Yes 122 https://www.protriage.co.uk/training/video/debrief-dental-problem https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4855.mp4 Debrief - Dental problem Dental Problem Assessment and Airway Check Introduction Patient's Dental Issue: The patient presented with a dental problem, having neglected treatment after fracturing a tooth. Importance of Airway Examination Ensuring Airway Safety: In dental cases, it is crucial to inspect the mouth thoroughly to ensure no swelling obstructs the airway. Medical Procedure Steps to Follow: Once the airway safety is confirmed, the patient can proceed to be assessed by the GP for further treatment. https://d3imrogdy81qei.cloudfront.net/video_images/8643/Debrief_-_Dental_problem-01.jpg Yes 33 https://www.protriage.co.uk/training/video/debrief-minor-arm-injury https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4851.mp4 Debrief - Minor arm injury Handling Upper Limb Injury in Triage Initial Presentation and Triage Approach This patient presented with an injury to their arm, specifically the shoulder, involving the upper limb. Quick Triage: I aimed to expedite the triage process, attempting to use the blood pressure cuff on the affected arm. Consideration: Before placing the cuff, it's crucial to ask, "Is it okay to use this arm?" This ensures safety, especially for patients with lymph node issues or fistulas in the limb. Assessment and Distinction Incident Clarification: For patients with minor injuries like this patient who fell, it's important to determine whether it was a fainting episode or a trip resulting in injury. Neurovascular Assessment: Check for any deficits distal to the injury, including pulses and sensation. Ring Removal: Always remove rings from the affected limb to prevent complications, unless there's a major deformity, compound fracture, or neurovascular deficit. Treatment and Care Supportive Measures: Patients with minor injuries may require a sling or other supportive measures, along with adequate pain relief while awaiting further assessment. https://d3imrogdy81qei.cloudfront.net/video_images/8635/Debrief_-_Minor_arm_injury-01.jpg Yes 116 https://www.protriage.co.uk/training/video/debrief-falls-vs-collapse https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4853.mp4 Debrief - Falls vs collapse Patient Assessment: Fall and Arm Injury Introduction to Patient Scenario Scenario Overview: The patient has fallen over and injured his left arm. Assessment of Fall vs Collapse Key Questions: It's crucial to differentiate between a fall and collapse. What were you doing before you fell? Did you lose consciousness? Did you hit your head? Was it a witnessed fall? How did you fall? (e.g., outstretched hand, backwards) Any chest pain or dizziness? Did you feel impending doom or tunnel vision? These questions help rule out neurological, cardiac, or mechanical causes. Patient's Account and Clinical Decision Patient's Account: He tripped over the carpet, fell forward with an outstretched hand, and briefly blacked out. Assessment: No loss of consciousness established. Pain Management: With a pain score of two at rest, we applied a sling for comfort and instructed him to minor injuries. Importance of Ring Removal Risk Management: Advised removal of his ring due to potential swelling complications. This approach ensures proper care and minimizes future complications for the patient. https://d3imrogdy81qei.cloudfront.net/video_images/8639/Debrief_-_Falls_vs_collapse-01.jpg Yes 107 https://www.protriage.co.uk/training/video/debrief-head-injury https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4854.mp4 Debrief - Head injury Assessment and Management of Head Injuries Introduction Overview: Triaging head injuries requires careful assessment based on established guidelines. Key Considerations in Head Injury Assessment Loss of Consciousness: It's crucial to determine if there has been any loss of consciousness. Loss of consciousness can indicate severity of head injury. Assess whether the patient fell with arms outstretched or not. Confusion and Alcohol Consumption: Confusion may stem from alcohol or head injury; check blood sugar levels if in doubt. Physical Examination Protocols Neck and Spinal Assessment: If the patient lost consciousness, assess for C-spine tenderness and immobilise accordingly. Important to prevent further injury to the neck. Facial and Dental Trauma: Check for injuries around the lower face and dental trauma. Inspect for bleeding, swelling, or airway obstruction. Palpate facial bones for tenderness or bogginess. Conclusion Final Assessment: Always conduct a thorough examination to rule out serious underlying injuries. https://d3imrogdy81qei.cloudfront.net/video_images/8641/Debrief_-_Head_injury-01.jpg Yes 103 https://www.protriage.co.uk/training/video/debrief-diarrhoea-and-vomiting https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4860.mp4 Debrief - Diarrhoea and Vomiting Assessment of Diarrhoea and Vomiting: Risk of Dehydration Common Condition with Dehydration Risk Overview: Patients presenting with diarrhoea and vomiting. Condition: Diarrhoea and vomiting are common ailments, but prolonged duration increases dehydration risk, especially considering the patient's age. Methods of Dehydration Assessment Skin Tenting Test: A quick test involves lifting the skin, as demonstrated in triage training. Failure of the skin to return promptly to its normal position indicates dehydration. Mucous Membrane Check: Examine the patient's mouth and tongue. Dryness or lack of moisture in the mucous membranes may indicate dehydration. https://d3imrogdy81qei.cloudfront.net/video_images/8665/Debrief_-_Diarrhoea_and_Vomiting-01.jpg Yes 61 https://www.protriage.co.uk/training/video/debrief-eye-injury https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4856.mp4 Debrief - Eye injury Eye Complaints Triage and Assessment Importance of History in Eye Complaints Key Role of History: When assessing eye complaints, the patient's history plays a crucial role. Symptoms like foreign body sensation can occur even if no actual foreign body is visible. Case Example and Symptoms Case Example: The patient was grinding without goggles when he felt a foreign body hit his eye, leading to pain and watering—a typical presentation. Role of Triage Assessment Assessing for Foreign Bodies: In triage, it's essential to physically check for any visible foreign bodies. Even if flushed out by eye wash, scratches or other injuries may still be present, warranting further examination by A&E doctors. Initial Eye Assessment Checking Eye Functionality: An initial assessment in triage includes checking pupil reaction and ensuring the eye moves and functions correctly. Conclusion Next Steps: Patients with eye complaints should be promptly referred to A&E for a detailed examination to rule out any underlying injuries or complications. https://d3imrogdy81qei.cloudfront.net/video_images/8649/Debrief_-_Eye_injury-01.jpg Yes 72 https://www.protriage.co.uk/training/video/debrief-poisoning https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4857.mp4 Debrief - Poisoning Managing Beta-Blocker Overdose: Triage Protocol Introduction Understanding Poisoning Cases: This incident involves a case of beta-blocker overdose, where the prescribed medication was taken in excess. Medical Background Prescription and Medical History: The patient was prescribed beta-blockers due to a history of heart arrhythmia, typically taken at a specific daily dosage. Assessment and Response Understanding Medication Effects: It's crucial to understand the effects of medications and monitor accordingly. Physical Assessment: Check the patient's pulse and blood pressure to assess the impact of the overdose. A manual check of the radial pulse helps evaluate pulse quality, regularity, and peripheral perfusion. Immediate Care Protocol Risk Management: Patients at risk of collapse should be placed on a trolley or chair and immediately transferred to A&E for comprehensive evaluation and treatment. https://d3imrogdy81qei.cloudfront.net/video_images/8653/Debrief_-_Poisoning-01.jpg Yes 69 https://www.protriage.co.uk/training/video/debrief-circumference-burn https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4858.mp4 Debrief - Circumference burn Circumferential Burn Assessment and Management Introduction Patient Presentation: The patient presented with a circumferential burn on the lower forearm. Assessment of Circumferential Burns Importance of Assessment: Circumferential burns require thorough assessment to ensure adequate perfusion and neurovascular function beyond the injury site. Skin and Tissue Perfusion: It is crucial to assess skin perfusion and sensory function distal to the burn. Severity Considerations Severity of Circumferential Burns: Burns encircling areas like the chest or abdomen are particularly serious due to potential complications. Immediate Actions Timely Assessment: Immediate evaluation of burns is essential to determine appropriate treatment and management. Consultation with Medical Professionals: When in doubt, consulting a doctor is recommended to ensure proper assessment and management of burns. Factors Influencing Burn Assessment Factors to Consider: Depth of the burn, skin condition, and patient's age are critical factors in assessing burn severity and appropriate care. https://d3imrogdy81qei.cloudfront.net/video_images/8657/Debrief_-_Circumference_burn-01.jpg Yes 83 https://www.protriage.co.uk/training/video/debrief-unknown-condition-possible-stroke https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4859.mp4 Debrief - Unknown condition - Possible stroke Assessment of Neurological Symptoms: CVA or TIA? Patient Presentation Initial Symptoms: Patient presented with vague symptoms upon waking up, making diagnosis challenging. Generalised Assessment: It's crucial to ask about general health, chest pain, and shortness of breath to rule out other conditions. Neurological Examination Findings Left-sided Weakness: Examination revealed weakness in the left upper and lower limbs, along with facial symptoms. FAST Positive: Patient demonstrated signs of Face, Arm, Speech, Time (FAST) positive, indicating a potential CVA (Stroke) or TIA (Transient Ischemic Attack). Emergency Response Immediate Referral: Patient to be expedited to A&E for urgent evaluation and potential imaging, ensuring treatment within the critical time window. Time-sensitive Treatment: It's essential to act promptly, as treatment for Ischemic stroke is most effective within 3 1/2 hours of symptom onset. Verify local treatment protocols and guidelines. https://d3imrogdy81qei.cloudfront.net/video_images/8659/Debrief_-_Unknown_condition_-_Possible_stroke-01.jpg Yes 66 https://www.protriage.co.uk/training/video/debrief-rectal-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4864.mp4 Debrief - Rectal bleeding Understanding Abdominal Pain and Bleeding Symptoms Challenges with Abdominal Pain and Bleeding Introduction: Patients presenting with abdominal pain and altered stools or rectal bleeding pose diagnostic challenges. Types and Causes of Rectal Bleeding Types of Bleeding: Rectal bleeding can vary depending on its source. Bright Red Blood: Indicates bleeding near the anal sphincter, possibly from haemorrhoids or fissures. Blood in Stools: Can indicate bleeding from higher up in the digestive tract if mixed with stools. Melena: Black, tarry, foul-smelling stools indicate digested blood from higher in the digestive tract. Significance of Melena Melena Description: Melena is a serious condition where digested blood emits a distinct smell, not typical of normal stools. Patient Experience: Patients often note the unusual odour of melena. Urgency of A&E Assessment Immediate Medical Attention: Any form of rectal bleeding, especially melena, requires urgent evaluation in A&E. https://d3imrogdy81qei.cloudfront.net/video_images/8669/Debrief_-_Rectal_bleeding-01.jpg Yes 81 https://www.protriage.co.uk/training/video/debrief-mental-health-depression https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4863.mp4 Debrief - Mental health - Depression Importance of Addressing Depression in Patients Treating Patients with Respect and Dignity Patients potentially suffering from depression must be treated with respect and dignity, similar to those with medical illnesses. Importance of Asking Difficult Questions During triage, it's crucial to ask difficult questions such as: Are they suicidal? Do they feel like killing themselves? If affirmative, appropriate action must be taken to ensure their safety and well-being. Recording Patient Appearance and Situation It's essential to record detailed observations: What they look like What clothes they are wearing Ensure they are accompanied and prevent them from leaving (absconding) Safeguarding Considerations in Postnatal Depression For postnatal patients, like the case discussed, who had a baby four weeks ago: Establishing the whereabouts and safety of the baby is critical. This information wasn't gathered during triage but is crucial for safeguarding. Addressing these issues is necessary to ensure the well-being of both the patient and the infant. https://d3imrogdy81qei.cloudfront.net/video_images/8683/Debrief_-_Mental_health_-_Depression-01.jpg Yes 60 https://www.protriage.co.uk/training/video/managing-patient-expectations https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4886.mp4 Managing patient expectations Managing Patient Expectations in Triage: Tips and Insights Understanding Patient Expectations Exploring strategies to manage patient expectations effectively during triage: Common Challenges: Patients often arrive with expectations for immediate treatment or specific interventions that may not align with the rapid assessment nature of triage. Experience with Patient Expectations: Addressing instances where patients anticipate outcomes that triage may not directly provide. Strategies for Effective Management Insights into handling patient expectations during the triage process: Setting Clear Expectations: Communicate early on that triage involves a rapid assessment to determine appropriate next steps rather than detailed treatment. Emphasising Safety and Assessment: Ensure patients understand the primary goal is to assess their condition swiftly and direct them to the appropriate level of care. Avoiding False Promises: Refrain from guaranteeing specific tests or treatments (e.g., x-rays, blood tests) during triage to manage expectations realistically. Documenting and Updating: Accurately record patient assessments and decisions made during triage to maintain clarity and continuity of care. By adhering to these practices, healthcare providers can navigate patient expectations effectively in triage settings. https://d3imrogdy81qei.cloudfront.net/video_images/8729/Managing_patient_expectations-01.jpg Yes 115 https://www.protriage.co.uk/training/video/head-injury https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4833.mp4 Head injury Assessment of Head Injury and Assault Introduction to Patient Assessment Introduction: I'm Mark, the triage nurse today. We'll quickly assess your condition to determine appropriate care. Patient Identification Patient Details: Name: Charles Dunnigan, Date of Birth: 16/05/64 Initial Assessment and History Initial Assessment: We'll check your blood pressure and discuss your symptoms. Are you comfortable with me checking your blood pressure? Any particular arm you prefer? History of Presenting Complaint: Charles reports being punched without provocation, resulting in headache and dizziness. Assessment of Injury and Symptoms Symptoms: Charles experienced dizziness, headache, and visual disturbances post-assault. Did you lose consciousness? Do you have any neck pain or stiffness? Any visual disturbances or sensitivity to light? Physical Examination: No signs of significant head or neck injury noted, aside from jaw tenderness and headache. Medical History and Medication Medical History: No known medical conditions or current medications. Any drug allergies? Have you experienced similar symptoms before? Clinical Decision and Next Steps Clinical Decision: Considering the head injury and symptoms, Charles will be referred to an A&E doctor for further assessment and investigations. We'll check your blood sugar levels as a precaution. You may need imaging tests to assess for any internal injuries. Final Instructions Discharge: Charles will be directed to A&E for comprehensive evaluation and management. Would you prefer to walk or use a wheelchair? Head towards the waiting area by the TVs and wait to be called. Thank you for your cooperation, Charles. We'll ensure you receive the necessary care promptly. https://d3imrogdy81qei.cloudfront.net/video_images/8645/Head_injury-01.jpg Yes 288 https://www.protriage.co.uk/training/video/rectal-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4889.mp4 Rectal bleeding Initial Assessment at Triage: Patient with Abdominal Pain Introduction to Triage Assessment Introduction: Hi, I'm Mark, the triage nurse today. Could I please confirm your name and date of birth? Patient Details: Yes, it's Brenda King, born on the 1st of June, 1964. Quick Initial Assessment Triage Overview: Triage involves a quick initial assessment to direct you to the appropriate care. Blood Pressure Check: Let's check your blood pressure while we talk. Medical History: Brenda reports abdominal pain persisting for a week, with unusual stool consistency resembling tar and a foul smell. Assessment Details Discussion: Brenda's symptoms include widespread bellyache and abnormal stool characteristics. Concerns: Possible gastrointestinal bleeding indicated by stool appearance. Next Steps: Urgent referral to A&E for further evaluation and investigations. Conclusion and Instructions Further Instructions: Brenda, please proceed to A&E. Avoid taking additional medication until assessed by the doctor. Direction: Follow the corridor, turn right, third door on the left. Take a seat and you will be attended to shortly. https://d3imrogdy81qei.cloudfront.net/video_images/8687/Rectal_bleeding-01.jpg Yes 236 https://www.protriage.co.uk/training/video/pulse-and-pulse-oximetry-in-the-medical-sector https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4893.mp4 Pulse and pulse oximetry in the medical sector Pulse Oximeter Usage and Interpretation Introduction The pulse oximeter is a crucial tool for assessing oxygen saturation and pulse rate. Important Points: Measures percentage of oxygen attached to haemoglobin. Typically used on patients with respiratory conditions like COPD. Usage and Procedure Placement and Procedure: Place the pulse oximeter on the patient's finger. Ensure the finger is clean and free from obstruction. Use any finger except the one used for blood pressure measurement. Considerations: Ensure the finger is clean and unimpeded by substances like grease or nail varnish. For children, use appropriate-sized probes designed for their age. Interpretation and Intervention Readings: Ideal oxygen saturation is 96% or above. If oxygen saturation falls below 88%, it indicates an emergency. Additional Assessments: Check pulse rate audibly and manually for strength and regularity. Assess capillary refill time by pressing fingernail and observing color change. Assessment of Capillary Refill Procedure: Press fingernail down for five seconds. Release and observe time taken for fingernail to return to pink color. Interpretation: Capillary refill should occur within two seconds. Delayed refill indicates potential circulation problems. Conclusion Understanding pulse oximeter readings and additional assessments like capillary refill time is essential for effective patient care and timely intervention. https://d3imrogdy81qei.cloudfront.net/video_images/8711/Pulse_and_pulse_oximetry_in_the_medical_sector-01.jpg Yes 298 https://www.protriage.co.uk/training/video/debrief-ear-nose-and-throat https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4865.mp4 Debrief - Ear, nose and throat Assessment of Sore Throat and Sore Ear Overview of Patient Presentation Chief Complaint: The patient presented with complaints of a sore throat and a sore ear, which may be related. Physical Examination Focus Throat Examination: It is essential to examine the mouth for any signs of airway obstruction due to swelling. Ear Examination: Additionally, inspect behind the ear to assess the mastoid bone for signs of swelling, redness, and tenderness. Assessment of Mastoid Area Observation Technique: Viewing the patient square-on helps in detecting any protrusion of the affected ear, indicating potential mastoid area swelling. Referral and Further Evaluation Referral Decision: If the airway remains clear, consider referral to the GP for further evaluation. The GP may decide on an ENT (ear, nose, and throat) referral based on findings. https://d3imrogdy81qei.cloudfront.net/video_images/8671/Debrief_-_Ear__nose_and_throat-01.jpg Yes 51 https://www.protriage.co.uk/training/video/ear-nose-and-throat https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4876.mp4 Ear, nose and throat Assessment of Earache and Sore Throat Introduction to Triage Assessment Greeting and Confirmation: Hello, I'm Mark, the triage nurse on duty tonight. Could you please confirm your name and date of birth for me? Patient Details: Yes, it's Dave Smith, 16th May '64. Overview of Triage Process Triage Explanation: Triage involves a quick assessment to determine the appropriate next steps for your care. Blood Pressure Check: Could we check your blood pressure while we talk? Patient's Symptoms and Concerns Chief Complaint: Dave presents with earache and a sore throat. Ear Symptoms: Initially started with earache and a sensation of water, now painful. Throat Symptoms: Severe throat pain making swallowing difficult despite over-the-counter remedies. Assessment and Findings Initial Assessment: Temperature slightly elevated, pulse elevated. Physical Examination: Examined throat and ear for signs of infection and discomfort. Recommendation for Further Care Next Steps: Based on symptoms, referral to GP at the Urgent Care Centre for further evaluation and treatment. Medication: Doctor likely to prescribe suitable pain relief considering the severity of throat pain. Conclusion and Directions Direction to Urgent Care: To reach the Urgent Care Centre, exit here, turn right, https://d3imrogdy81qei.cloudfront.net/video_images/8685/Ear__nose_and_throat-01.jpg Yes 215 https://www.protriage.co.uk/training/video/blood-pressure- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4875.mp4 Blood pressure Blood Pressure Assessment: Procedure and Considerations Introduction Before taking your blood pressure, let's ensure proper preparation and understanding of the process. Preparation Confirm patient consent and readiness. Ensure hands are washed and gloves are worn. Verify equipment cleanliness. Procedure Begin by selecting the appropriate arm and cuff size for accurate readings. Arm Selection: Use the left arm due to optimal arterial configuration. Consider alternatives for patients with specific arm conditions or injuries. Cuff Size: The cuff should cover at least 80% of the upper arm's distance between the axilla and elbow. The inflatable portion should cover at least 40% of the upper arm's circumference. Placement: Position the cuff snugly on the arm, ensuring direct contact with the skin. Align the cuff arrow with the brachial artery for accurate measurement. Execution: Inflate the cuff and maintain arm position at heart level. Avoid arm movement during measurement to prevent erroneous readings. Considerations Monitor cuff tightness, especially in elderly patients or those on blood thinners. Account for individual factors such as age, medication, and medical history. Interpretation Review the displayed blood pressure readings, focusing on systolic and diastolic values. Systolic (Top Number): Represents heart contraction force against arterial walls. Diastolic (Bottom Number): Indicates heart relaxation between beats. Conclusion Remember, blood pressure assessment is part of a comprehensive evaluation, considering various factors to derive accurate insights into a patient's health. https://d3imrogdy81qei.cloudfront.net/video_images/8743/Blood_pressure-01.jpg Yes 386 https://www.protriage.co.uk/training/video/news2-and-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4890.mp4 NEWS2 and triage Understanding the NEWS2 System in Triage Overview of NEWS2 in Triage Exploring the role of the National Early Warning Score (NEWS2) in rapid assessment and triage: Diagnostic Role: NEWS2 involves gathering vital signs like blood pressure, temperature, etc., to calculate a predictive score. Predictive Function: NEWS2 predicts the patient's acuity and guides the level of care they require based on their current condition. Components of the NEWS2 Score Understanding the physiological parameters included in the NEWS2 score: Key Parameters: Includes respiratory rate, pulse rate, pulse oximetry, conscious level, blood pressure, and pain scores. Significance of Parameters: Each parameter's abnormality contributes to an overall score, indicating the patient's risk of deterioration. Interpreting NEWS2 Scores Guidelines for interpreting NEWS2 scores and their implications: Severity Levels: A score of 5 or above indicates a need for urgent intervention and higher dependency care. Immediate Action: Individual parameter scores of 3 highlight specific concerns requiring urgent assessment and intervention. Utilizing NEWS2 helps in early identification of patients at risk of deterioration, facilitating prompt and appropriate medical intervention. https://d3imrogdy81qei.cloudfront.net/video_images/8735/NEWS2_and_triage-01.jpg Yes 152 https://www.protriage.co.uk/training/video/taking-the-temperature---medical-settings https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4891.mp4 Taking the temperature - medical settings Temperature Measurement Procedure: Ear Thermometer Introduction Let's proceed with measuring your temperature using an ear thermometer. Procedure We will be using an ear thermometer to measure your temperature at the tympanic membrane. Equipment: Ear thermometer Probe cover Instructions: Place a sterile probe cover on the thermometer. Insert the thermometer into either ear. Press the button to obtain a digital temperature reading. Recording: Record the temperature reading obtained. Interpretation The temperature reading indicates the body's response to pathogens, infection, or inflammation. Importance: It serves as an indicator of health status and potential illnesses. Rapid changes in temperature may signify allergic reactions or medication effects. Cleanup Dispose of used probe covers in the designated yellow bin. Conclusion Temperature measurement is an essential component of patient assessment, providing valuable insights into overall health and potential medical conditions. https://d3imrogdy81qei.cloudfront.net/video_images/8693/Taking_the_temperature_-_medical_settings-01.jpg Yes 106 https://www.protriage.co.uk/training/video/observations-of-vital-signs-introduction https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4867.mp4 Introduction - Observations of vital signs Triage Scenarios and Vital Signs Assessment in A&E Importance of Vital Signs in Triage Each patient in A&E triage undergoes a thorough assessment including: Full Set of Vital Signs: Includes blood pressure, pulse, temperature, saturations, and respiration rate, establishing a baseline for further observations. Baseline for Comparison: These initial observations serve as a baseline against which subsequent vital signs are compared. A-E Assessment Framework The triage nurse follows the A-E assessment framework: Subconscious Assessment: Airway, breathing, circulation, neurological disability, and exposure are assessed, often subconsciously integrated into the triage process. Importance of Pulse Assessment During observations, it's crucial to assess the pulse: Quality of Pulse: Assessing the regularity and character of the pulse provides valuable insights into the patient's condition. By incorporating these assessments, triage nurses ensure thorough evaluation and effective initial management of patients in A&E. https://d3imrogdy81qei.cloudfront.net/video_images/8675/Introduction_-_Observations_of_vital_signs-01.jpg Yes 69 https://www.protriage.co.uk/training/video/mental-health-and-telephone-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4887.mp4 Mental health and telephone triage Triage Strategies for Patients with Mental Health Issues Challenges of Triage in Mental Health Cases Addressing the complexities of triaging patients with mental health concerns: High Workload Impact: Mental health crises often constitute a significant portion of out-of-hours triage demands. Communication Difficulties: Patients may struggle to articulate their condition or may resist speaking during consultations. Effective Approaches in Triage Strategies to manage and support mental health patients during triage: Empathetic Approach: Treat every mental health patient with compassion and patience, ensuring they feel heard and understood. Risk Assessment: Assess the immediate risk of self-harm or suicidal ideation through careful questioning about intentions and plans. Utilizing Available Information: Gather details about current medications and their dosages to gauge the patient's condition management. Escalation Protocols: If there is a perceived risk of harm and communication abruptly stops, escalate the case to emergency services, potentially involving ambulance and police services. Following such incidents, ensure thorough documentation and appropriate referrals to safeguarding boards for vulnerable adult protection. https://d3imrogdy81qei.cloudfront.net/video_images/8733/Mental_health_and_telephone_triage-01.jpg Yes 166 https://www.protriage.co.uk/training/video/additional-considerations- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4872.mp4 Additional considerations Telephone Triage Challenges and Solutions Challenges Faced in Telephone Triage Identifying Challenging Groups: Telephone triage can be particularly challenging when dealing with very elderly individuals, young children, persons with learning difficulties, and accidental callers to 111. Handling Different Demographics Every Call Matters: Regardless of who calls, every 111 inquiry is treated seriously, and demographic information is gathered as thoroughly as possible. Children Calling 111: Children sometimes call 111 seeking help independently. In such cases, safeguarding measures may need to be considered, including local safeguarding referrals. Elderly and Vulnerable Callers: Elderly and vulnerable individuals may call 111 for various reasons, sometimes simply for companionship or advice. They are directed to appropriate services to address their needs, including mental health support or assistance with daily living. Overcoming Language Barriers Language Challenges: Language barriers, such as patients speaking broken English, can complicate triage. Services like Language Line are used to facilitate communication effectively, ensuring accurate information gathering and credible documentation. Ensuring Safety and Credibility: Using Language Line enhances safety and credibility by avoiding assumptions and ensuring accurate understanding of patient needs. Dealing with Accidental Calls Handling Wrong Numbers: Accidental calls to 111, such as mistaking it for the police non-emergency line (101), are managed carefully. Details are recorded, and appropriate signposting to other services, if needed, is provided before redirecting the caller. Children and Accidental Calls: Even accidental calls from children are documented and handled with care, ensuring all details are recorded for proper management. https://d3imrogdy81qei.cloudfront.net/video_images/8677/Additional_considerations-01.jpg Yes 178 https://www.protriage.co.uk/training/video/computer-based-telephone-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4898.mp4 Computer-based telephone triage Telephone Triage Process and Documentation Introduction to Telephone Triage Exploring the process of conducting telephone triage using the Adastra platform: Platform Overview: Adastra platform facilitates remote consultations akin to face-to-face assessments. Patient Verification: Confirming patient identity by verifying name and date of birth before documentation to ensure accuracy. Establishing Rapport: Introducing oneself and clarifying roles within the organisation to enhance patient comfort and cooperation. Components of Consultation Documentation Understanding the elements covered during the telephone triage consultation: History Collection: Gathering information on presenting complaints, medical history, medications, allergies, and social circumstances. Treatment Discussion: Documenting advice given, including self-care recommendations, medication instructions, and safety precautions. Safety Netting: Highlighting follow-up instructions such as monitoring symptoms and recognizing red flag warning signs. Concluding the Consultation Final steps to conclude and ensure patient understanding and agreement: Confirmation of Plan: Ensuring the patient comprehends and consents to the outlined plan before closing the consultation. Prescription Handling: Directing prescriptions either electronically or to a preferred pharmacy, considering out-of-hours arrangements. Case Closure: Reviewing and finalizing consultation notes before categorizing the case as self-care, clinic visit, or home visit. Implementing thorough documentation and clear communication in telephone triage ensures effective patient management and continuity of care. https://d3imrogdy81qei.cloudfront.net/video_images/8739/Computer-based_telephone_triage-01.jpg Yes 263 https://www.protriage.co.uk/training/video/preparing-for-clinical-observations https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4888.mp4 Preparing for clinical observations Clinical Observations: Precautions and Equipment Hygiene Precautions Before Clinical Observations Mark, before we proceed with clinical observations, let's discuss the precautions: Standard Precautions: If you're not dealing with an infectious risk, gloves are sufficient. Hand Hygiene: Always wash hands thoroughly before wearing gloves and ensure they are properly dried. Special Precautions: For high-risk patients, we use PPE (Personal Protective Equipment) such as gloves, gown, plastic apron, face mask, and face shield. Cleaning of Equipment All equipment is cleaned: Between Patients: Equipment is cleaned thoroughly after each patient interaction. Data Entry and Hand Hygiene When entering data or making phone calls: After Patient Contact: Remove gloves, clean hands with alcohol gel or wash them, then proceed with data entry or phone calls. Before Re-approaching Patient: Clean hands again and put on fresh gloves. Cleaning Small Equipment Regarding small items like penlight torches and pens: Keep Clean: Items like penlight torches and pens must be kept clean. Procedure: Remove gloves, clean hands, ensure equipment is clean before use, and handle with the same gloves if not contaminated. These protocols ensure infection control and safety during clinical observations. https://d3imrogdy81qei.cloudfront.net/video_images/8689/Preparing_for_clinical_observations-01.jpg Yes 129 https://www.protriage.co.uk/training/video/establishing-patient-presentations https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4880.mp4 Establishing patient presentations Establishing Patient Complaints: Tips and Strategies in Triage Understanding the Patient's Complaint Exploring effective methods to uncover and understand the patient's narrative: Key Information Gathering: Start by learning what happened, when it occurred, and its severity. Assess injuries directly if visible under bandages or plasters to check for bleeding, infection, or deformity. Non-Verbal Communication: Recognise the significance of non-verbal cues, especially helpful when language barriers exist. Encourage patients to point to areas of discomfort or use tools like Language Line for interpreters. Challenges with Dementia Patients Addressing specific challenges and solutions when dealing with dementia patients: Importance of Accompanying Carers: Patients with dementia benefit greatly when accompanied by a family member or carer who understands their condition. Role of the Carer: Carers often act as interpreters, providing valuable insights into the patient's needs and aiding in effective communication and care decisions. Utilising these strategies ensures thorough understanding and effective communication in triage settings, enhancing patient care and satisfaction. https://d3imrogdy81qei.cloudfront.net/video_images/8723/Establishing_patient_presentations-01.jpg Yes 123 https://www.protriage.co.uk/training/video/awkward-patient-and-antibiotics https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4902.mp4 Scenario 4 - Awkward patient and antibiotics Urgent Care Call with Mr Smith: Ear Infection Assessment Introduction and Identification Introduction: Shawn, an Urgent Care practitioner, contacts Mr Smith regarding his ongoing ear issue. Assessment of Current Condition Current Symptoms: Mr Smith expresses frustration with his ear infection and the ineffectiveness of previous treatments. Medical History and Treatment Medical Background: Discussion on previous antibiotics and pain relief medications taken by Mr Smith. Physical Examination and Next Steps Recommendation: Urgent referral to the Royal Stoke Hospital Urgent Care Centre for a thorough examination and appropriate treatment. Arranging the Urgent Care Appointment Appointment: Details provided for Mr Smith to attend the Royal Stoke Hospital Urgent Care Centre for assessment. Final Instructions and Follow-Up Instructions: Mr Smith advised to await a call for appointment details and contact 111 in case of worsening symptoms or changes before the appointment. https://d3imrogdy81qei.cloudfront.net/video_images/8749/Scenario_4_-_Awkward_patient_and_antibiotics-01.jpg Yes 483 https://www.protriage.co.uk/training/video/circumference-burn https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4845.mp4 Circumference burn Management of Burn Injury: Triage Protocol Introduction Triage Assessment: Hello, I'm Mark, the triage nurse on duty today. We just need to confirm your details. Patient Details Confirming Patient Information: Patient's name is Mark Davis, date of birth 16/07/63. Assessment and Treatment Quick Triage Process: This is a quick assessment to determine the appropriate care pathway. Incident Description: The patient sustained a burn injury while attempting to light a petrol-driven Primus stove, causing pain and visible burns around the wrist. Medical Checks Vital Signs: Checked blood pressure and temperature. Oxygenation levels are stable. Medical History: Patient reports no past medical issues or allergies. Physical Examination Assessing Burn Severity: Examined the affected arm for nerve and blood supply integrity due to the burn encircling the wrist. Observations: Note paleness and coolness in the affected area, with sensations of pins and needles. Next Steps Treatment Plan: Administered initial pain relief and preparing to transfer the patient to a doctor for further evaluation and treatment. Patient Management: Patient will receive additional paracetamol and immediate medical attention for burn care. https://d3imrogdy81qei.cloudfront.net/video_images/8655/Circumference_burn-01.jpg Yes 173 https://www.protriage.co.uk/training/video/debrief-vaginal-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4843.mp4 Debrief - Vaginal bleeding Assessment of Vaginal Bleeding: Key Points and Management Overview Vaginal bleeding can indicate significant blood loss, which is measured by the number of sanitary pads used per hour. Key Points to Consider Blood Loss Measurement: Use of three or more sanitary pads per hour indicates significant bleed. Duration: Establish how long the bleeding has been occurring. Colour and Nature: Old blood appears brown, while fresh bleeding is typically red. Pregnancy: If applicable, pregnancy status is crucial information. Monitoring Vital Signs It is crucial to monitor the patient's: Blood Pressure: Watch for changes as the body compensates for blood loss. Pulse: Note increases as blood pressure decreases, indicating narrowing pulse pressure. Conclusion By assessing these key points and monitoring vital signs, healthcare providers can effectively manage cases of vaginal bleeding and provide appropriate care. https://d3imrogdy81qei.cloudfront.net/video_images/8759/Debrief_-_Vaginal_bleeding-01.jpg Yes 70 https://www.protriage.co.uk/training/video/blood-sugar-testing-hospital https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4873.mp4 Blood sugar testing Blood Sugar Measurement in Triage Introduction Blood sugar monitoring is essential, especially for patients with diabetes or those exhibiting symptoms of abnormal blood sugar levels. Important Points: Blood sugar levels indicate potential medical conditions such as diabetes or hypoglycemia. Proper technique and interpretation are crucial for accurate results. Procedure Finger Selection: Avoid using the middle, index, or thumb fingers for blood sugar testing. Select a less commonly used finger to minimize infection risk. Cleaning: Use water instead of alcohol to clean the finger to avoid affecting the reading. Avoid touching the end of the blood sugar strip to maintain accuracy. Blood Collection: Use a lancet to create a small puncture on the selected finger. Wipe away the initial blood sample and collect the second drop for testing. Measurement: Insert the blood sugar strip into the meter to initiate testing. Observe the display for the blood sugar reading. Interpretation Normal Range: Ideal blood sugar levels range from 4 to 8 mmol/L. Values below 4 indicate hypoglycemia and may require immediate intervention. Values above 8 may indicate hyperglycemia and potential diabetes onset. Considerations: Assess patient history and current condition for context. Food intake prior to testing may affect readings. Conclusion Accurate blood sugar measurement is vital for diagnosing and managing various medical conditions. Proper technique and interpretation ensure effective patient care. https://d3imrogdy81qei.cloudfront.net/video_images/8681/Blood_sugar_testing-01.jpg Yes 311 https://www.protriage.co.uk/training/video/tonsillitis https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4899.mp4 Scenario 1 - Tonsillitis Telephone Consultation for Sore Throat: Guidance and Treatment Introduction Initial Contact: Mr. Smith, a patient, contacts the out-of-hours service with throat concerns. Verification of Patient Details Confirmation: Urgent care practitioner verifies Mr. Smith's identity and reason for calling. Symptoms Assessment Presenting Symptoms: Mr. Smith reports severe throat pain exacerbated by swallowing, along with joint ache and swollen glands under his jawline. Medical History and Current Condition Medical Background: No significant medical history except hay fever, no current medications other than paracetamol. Diagnosis and Treatment Plan Possible Diagnosis: Suspected acute tonsillitis based on symptoms and visual inspection. Treatment Plan: Prescribing a 10-day course of penicillin-based antibiotics. Guidance for Mr. Smith Medication Instructions: Take antibiotics as prescribed, spaced from meals for optimal absorption. Supportive Care: Continue using paracetamol for pain relief, ensure adequate fluid intake. Monitoring: Watch for worsening symptoms such as severe throat pain, difficulty swallowing, or breathing problems. Emergency Protocol: In case of emergency (severe symptoms), dial 999 immediately. Follow-up: If symptoms persist after 2-3 days or worsen, contact GP for review. Conclusion of Call Closure: End of consultation with instructions reiterated and patient understanding confirmed. https://d3imrogdy81qei.cloudfront.net/video_images/8745/Scenario_1_-_Tonsillitis-01.jpg Yes 432 https://www.protriage.co.uk/training/video/existing-medications https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4882.mp4 Existing medications Managing Existing Medication in Triage: Importance and Considerations Understanding the Impact of Existing Medication Exploring the significance of existing medication and its implications in the triage process: Effect on Vital Signs: Medication can alter physiological responses, such as artificially lowering blood pressure or pulse rates, which may obscure the true condition of the patient. Patient Awareness: There's often a disconnect where patients may not fully understand their medications or their purposes, posing challenges during assessment. Challenges and Considerations Addressing common issues and considerations when managing medication in triage: Overdosing Concerns: Monitoring for unintentional overdoses, such as with paracetamol or combinations like paracetamol with co-codamol, is crucial due to potential cumulative effects. Alternative Therapies: Herbal remedies and cultural practices should also be noted as they can impact treatment decisions and patient outcomes. Substance Use: Approach with sensitivity when discussing illegal drugs or CBD usage, as patients may not disclose due to legal concerns, necessitating careful clinical judgment. Documentation in triage notes ensures accurate recording of factual information provided by the patient. https://d3imrogdy81qei.cloudfront.net/video_images/8731/Existing_medications-01.jpg Yes 245 https://www.protriage.co.uk/training/video/debrief-urine-retention https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4850.mp4 Debrief - Urine retention Urgent Assessment for Urinary Retention in A&E Patient Presentation Upon assessment, the patient reported difficulty passing urine. Further inquiry revealed he has an enlarged prostate and is taking Tamsulosin, suggesting a potential case of urinary retention. Importance of Prompt Action Significance: Given the symptoms and medical history, prompt assessment and intervention were crucial to rule out urinary retention. Plan for Treatment Next Steps: Due to the patient's presentation and history of prostate issues, immediate evaluation in A&E was warranted to ensure appropriate management. https://d3imrogdy81qei.cloudfront.net/video_images/8633/Debrief_-_Urine_retention-01.jpg Yes 52 https://www.protriage.co.uk/training/video/triage-categories https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4904.mp4 Triage categories Triage Categories in Emergency Care Explained Understanding Triage Categories When patients arrive for triage, they are categorised based on the severity of their condition: Immediate Response (Red Category): Patients needing urgent attention within zero minutes, typically directed to the resuscitation area. Examples include compromised airways or severe trauma. Very Urgent (Orange Category): Patients requiring attention within 10 minutes. This includes cases such as active bleeding or high pain scores necessitating IV analgesia. Urgent (Yellow Category): Patients needing assessment within 60 minutes, often treated in majors or ambulatory units. Examples include conditions like cellulitis requiring IV antibiotics. Standard (Green Category): Patients with less acute conditions, to be seen within 120 minutes. Includes minor injuries or referrals from GPs not suitable for walk-in centres. Non-urgent (Blue Category): Patients requiring assessment within 240 minutes. These cases may be referred to community services, their GP, or a minor injuries unit. Implementation Across Hospitals Despite variations in physical locations, the triage categorisation process remains consistent across hospitals: The categorisation does not alter the response time or outcome, ensuring uniformity in emergency care. Each hospital designates specific areas for different triage categories, such as resuscitation for red patients. Understanding these categories helps streamline patient care and ensures appropriate prioritisation in emergency departments. https://d3imrogdy81qei.cloudfront.net/video_images/8737/Triage_categories-01.jpg Yes 212 https://www.protriage.co.uk/training/video/professional-considerations https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4905.mp4 Professional considerations Recording Triage Encounters and Documentation Guidelines Importance of Recording Telephone Triage When conducting triage over the phone, it's crucial to understand the implications of recording conversations: Benefit of Recording: Recorded conversations serve as valuable support in case your notes or decisions are questioned. Documentation Equivalence: Notes from telephone triage should mirror those from face-to-face encounters, documenting comprehensive and relevant information. Safeguarding and Ethical Considerations It's essential to handle sensitive information and ethical concerns appropriately: Child Protection: Any indication of child endangerment must be documented and reported through your organisation's incident reporting system, potentially involving the police during out-of-hours periods. Vulnerable Adults: Incidents involving vulnerable adults should be reported to local safeguarding boards to ensure their protection. Ethical Practices with Palliative Patients: For patients in palliative care, gather comprehensive information including do-not-attempt-CPR plans, ReSPECT paperwork, and advanced care plans. Discuss these details with the family to inform decision-making processes. By adhering to these guidelines, you ensure thorough documentation and ethical practice in telephone triage scenarios. https://d3imrogdy81qei.cloudfront.net/video_images/8741/Professional_considerations-01.jpg Yes 150 https://www.protriage.co.uk/training/video/penlight https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4868.mp4 Penlights Neurological Assessment: Evaluating Pupillary Reflex Understanding the Importance During assessment or triage, it's crucial to examine patients for potential head injuries or neurological deficits, as these may indicate underlying brain problems. Using a Pen Light A pen light is a valuable tool for detecting signs of brain swelling or pressure on the optic nerve. Procedure: Clean the pen light before use. Activate the light by pressing the clip. Shine the light into both eyes. Observe pupil reaction to light exposure. Observations: Both pupils should retract equally when exposed to light. Repeat the process for each eye individually. Key Points: Ensure proper positioning of the light to avoid false readings. Use shading if necessary to aid pupil dilation. Check for equal and reflexive pupil responses. Recording: Record pupil size using the numbered scale on the pen torch. Interpreting Findings Unequal pupil size may indicate neurological deficits, requiring immediate referral to A&E. https://d3imrogdy81qei.cloudfront.net/video_images/8679/Penlights-01.jpg Yes 167 https://www.protriage.co.uk/training/video/respiration-types-and-rates https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4892.mp4 Respiration types and rates Assessing Respiration: Importance and Techniques Understanding Respiration Rate The respiration rate indicates the efficiency of breathing and is crucial for assessing overall health. Normal Range: Adults: 12 to 20 breaths per minute Significance: Observing the effort exerted by the patient during breathing. Changes in breathing patterns can indicate underlying health issues. Assessment Techniques Assessing respiration involves observing breathing patterns and physical indicators. Observation: Check for equal rise and fall of the chest. Assess the patient's ability to speak and form sentences. Observe for signs of gasping or labored breathing. Positional Clues: Patients may adopt specific positions to aid breathing, such as the tripoding stance. Use of Tools: Stethoscopes can provide additional insight into lung function and detect abnormalities. Procedure: Place the diaphragm of the stethoscope on the patient's skin. Listen at various locations on the chest, comparing breath sounds on both sides. Focus areas include the midclavicular line, back, and axilla. Considerations: Listening through clothing may reduce sound transmission. Patients should continue normal breathing during examination. Assessment aims to ensure equal lung function and detect abnormal breath sounds. https://d3imrogdy81qei.cloudfront.net/video_images/8695/Respiration_types_and_rates-01.jpg Yes 224 https://www.protriage.co.uk/training/video/chest-pain https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4900.mp4 Scenario 2 - Chest pain Emergency Call for Mrs Smith: Urgent Hospital Referral Initial Contact Introduction: Urgent care practitioner contacts Mr Smith regarding Mrs Smith's health concerns. Assessment of Mrs Smith's Condition Condition: Mrs Smith is unable to speak due to severe pain and difficulty breathing, with ongoing chest pain throughout the day. Medical History and Current Symptoms Medical Background: Mrs Smith has a history of heart problems, currently experiencing paleness and chest pain. Decision for Hospital Referral Recommendation: Urgent hospital visit required based on symptoms and medical history. Arranging Ambulance Service Ambulance Dispatch: An ambulance is being arranged to transport Mrs Smith to the hospital immediately. Final Instructions Instructions to Mr Smith: Await ambulance arrival at 12 Mornington Crescent, Snee Green. Contact 999 if conditions worsen before ambulance arrives. Closure of Call Conclusion: Call concludes with instructions reiterated and assurance given regarding ambulance dispatch. https://d3imrogdy81qei.cloudfront.net/video_images/8713/Scenario_2_-_Chest_pain-01.jpg Yes 149 https://www.protriage.co.uk/training/video/electronic-patient-records https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4877.mp4 Electronic patient records Recording Triage Episodes on Computer: Step-by-Step Guide Introduction to Triage Recording Mark and Shawn discuss the process of recording triage episodes electronically: Initial Steps: Introduce yourself to the patient, take physical observations, and gather history of complaints. Accessing Triage Details Tab: Navigate to the triage details section on the computer system. Data Entry: Enter date, time, and personal details followed by patient's physical observations. Entering Vital Signs Shawn demonstrates entering vital signs into the computer: Example 1 - Stable Patient: Respiratory rate 16, oxygen saturation 98%, temperature 36.8°C, systolic blood pressure 124, heart rate 68, pain score 2, alertness. Example 2 - Acutely Unwell Patient: Respiratory rate 38, oxygen saturation 91%, temperature 36.6°C, systolic blood pressure 120, heart rate 38, pain score 0. Automatic Calculation of NEWS Score Mark learns about the automated calculation of NEWS score based on vital signs: NEWS 2 Calculation: The computer computes the NEWS score automatically from entered vital signs. Example of Acute Illness: High NEWS score indicates severe condition prompting immediate action to transfer to resuscitation area. Understanding and correctly entering triage data ensures efficient patient management and appropriate medical response. https://d3imrogdy81qei.cloudfront.net/video_images/8701/Electronic_patient_records-01.jpg Yes 213 https://www.protriage.co.uk/training/video/the-goal-of-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4896.mp4 The goal of triage Understanding Triage and Patient Pathways in NHS Purpose of Triage Mark and Shawn discuss the fundamental aspects of triage: Definition of Triage: Derived from French, meaning 'to sort', it involves assessing and prioritising patients based on severity. Sorting Severity: Determines how quickly patients need to be seen and directs them to appropriate care pathways. Understanding Patient Pathways Mark explains the concept of pathways within the NHS: Definition of Pathway: Refers to the journey a patient takes through healthcare services based on their condition and needs. A&E Pathway Example: Patients proceed from triage to appropriate areas like minor injury units, doctor consultations, investigations, and discharge or admission. Pathway Flexibility: Tailored to the severity and nature of the illness or injury assessed during triage. Ensuring Patient Well-being and Completion of Treatment Shawn highlights the objective of initiating and completing patient care journeys: Starting the Journey: Begins with baseline observations and triage assessment. Completing the Journey: Aims for patients to leave hospital treated and fit, or admitted for further definitive care. Understanding these processes ensures efficient and effective patient management within NHS emergency departments. https://d3imrogdy81qei.cloudfront.net/video_images/8699/The_goal_of_triage-01.jpg Yes 91 https://www.protriage.co.uk/training/video/how-do-we-triage-correctly https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4884.mp4 How do we triage correctly Importance of Correct Triage Process in Healthcare Understanding Triage and Its Purpose Mark explains the fundamental aspects of triage: Initial Assessment: Triage ensures patients are swiftly placed on the appropriate treatment pathway for quick intervention and definitive care. National Early Warning Score (NEWS): Vital signs are input into the system to compute a NEWS score, indicating the severity of a patient's condition based on various metrics like blood pressure, pulse, and oxygen saturation. Pathway Adherence: Following established pathways is crucial, but flexibility may be needed based on patient assessment. Flexibility in Triage and Pathway Adherence Mark discusses the balance between following protocol and clinical judgment: Deviation from Protocol: Sometimes clinical judgment may necessitate deviation from the standard pathway, prioritizing patient needs over protocol adherence. Safeguards and Documentation: Use of system alerts and narrative notes ensures concerns are flagged for priority care and documented appropriately. Consulting and Collaborating for Safe Decisions Exploring additional options for handling complex cases: System Alerts: Utilize the triage system's alert feature (e.g., stethoscope icon) to notify doctors and nurses of urgent cases. Narrative Documentation: Detailed free-text notes provide a comprehensive overview of prioritized findings. Consulting Peers: Engage with healthcare professionals, including doctors and nurses, for second opinions and collaborative decision-making. Ensuring patient safety and optimal care through informed decisions and collaborative practices remains paramount in triage. https://d3imrogdy81qei.cloudfront.net/video_images/8707/How_do_we_triage_correctly-01.jpg Yes 232 https://www.protriage.co.uk/training/video/mental-health-depression https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4901.mp4 Scenario 3 - Mental health - Depression Urgent Care Call with Mr Smith: Mental Health Assessment Initial Contact and Identification Introduction: Shaun, an Urgent Care practitioner, contacts Mr Smith regarding his recent call. Assessment of Current Situation Current Concerns: Mark Smith discusses his feelings of hopelessness and recent changes in mood. Medical History and Medication Background: Mark reveals a history of depression, currently managed with amitriptyline. Evaluation of Emotional State Discussion: Shaun explores Mark's recent emotional struggles and thoughts of self-harm. Decision for Immediate Care Recommendation: Urgent referral to the Urgent Care Centre at Royal Stoke Hospital for assessment and support. Arranging the Appointment Appointment: Shaun explains the location and process for Mark to attend the appointment at the centre. Final Instructions and Follow-Up Instructions: Mark is advised to wait for a call regarding his appointment and to update if his condition changes. https://d3imrogdy81qei.cloudfront.net/video_images/8747/Scenario_3_-_Mental_health_-_Depression-01.jpg Yes 455 https://www.protriage.co.uk/training/video/discriminators https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4878.mp4 Discriminators Triage Process: Handling Patients with Ankle Injury and Urinary Symptoms Introduction to Triage Assessment Mark and Shawn discuss how to triage patients presenting with different conditions: Ankle Injury Scenario: Patient reports non-weight bearing and severe pain. Urinary Symptoms Scenario: Patient complains of pain while passing urine. Handling an Ankle Injury Shawn explains the process of triaging a patient with an ankle injury: Selecting Categories: Choose 'Trauma, Musculoskeletal' and specify 'Ankle' under presenting complaint. Pain Assessment: Patient reports pain as 10 out of 10, indicating 'Significant Pain'. Triage Category: Categorize as 'Very Urgent' for immediate assessment and possible IV analgesia. Pathway Selection: Direct patient to majors area for treatment. Managing Urinary Symptoms Discussing the triage approach for patients with urinary issues: Selecting Categories: Choose 'Triage, Illness' and specify 'Genitourinary Symptoms'. Pain Assessment: Patient reports pain as 4 out of 10, categorizing as 'Urgent'. Triage Category: Determine urgency based on symptoms like difficulty passing urine. Pathway Selection: Determine appropriate treatment area based on triage assessment. Understanding these steps ensures accurate triage categorization and timely patient care. https://d3imrogdy81qei.cloudfront.net/video_images/8703/Discriminators-01.jpg Yes 206 https://www.protriage.co.uk/training/video/what-is-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4897.mp4 What is Triage Understanding Triage in Emergency Settings Definition and Levels of Triage Mark and Shawn discuss the concept and levels of triage: Definition of Triage: Triage is derived from the French word meaning 'to sort'. It involves assessing and sorting patients based on the severity of their condition. Levels of Triage: Includes initial scene triage and major incident triage, adapting to different scenarios and resource needs. Importance of Dynamic Assessment: Quickly determines patient priority and resource requirements. Nurse's Perspective on Triage Mark explains the importance of triage from a nursing perspective: Initial Patient Assessment: Crucial for determining severity and necessary treatment. Consideration of Treatment Needs: Assessing not only severity but also treatment urgency. Pathway Decision-Making: Directing patients to appropriate care pathways to avoid A&E congestion. Effective Triage Process Mark and Shawn elaborate on the efficiency and accuracy of the triage process: Manchester Triage System: Utilises colour-coded urgency levels (Red, Orange, Yellow, Green, Blue) based on initial patient assessment. Speeding Up Patient Care: Ensures timely treatment and reduces waiting times by directing patients to the right care pathway. Importance of Accurate Assessment: Critical for assigning correct priority and ensuring appropriate treatment location. A to E Assessment Mark discusses the A to E assessment process during triage: A to E Assessment: Airway, Breathing, Circulation, Neurological Disability, and Exposure assessment. Quick Evaluation: Rapid assessment to gauge patient severity and immediate needs. Time Frame: Ideally completed within 10 minutes to expedite patient care. Patient Interaction and Satisfaction Mark addresses patient interaction and satisfaction during the triage process: Communication and Comfort: Balancing quick assessment with patient reassurance and understanding. Managing Expectations: Informing patients of the triage process and subsequent care pathway. Closure and Pathway Guidance: Concluding the triage process with clarity on next steps for the patient. Understanding and effectively implementing triage ensures patients receive timely and appropriate care, improving overall emergency department efficiency. https://d3imrogdy81qei.cloudfront.net/video_images/8715/What_is_Triage-01.jpg Yes 435 https://www.protriage.co.uk/training/video/lower-back-pain https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4903.mp4 Scenario 5 - Lower back pain Emergency Call with Mr Smith: Severe Back Pain Assessment Introduction and Identification Introduction: Shaun from Urgent Care contacts Mr Smith regarding severe back pain he experienced this afternoon. Assessment of Current Condition Current Symptoms: Mr Smith describes intense lower back pain radiating down his left leg, exacerbated by movement. Medical History and Pain Management Medical Background: Discussion on previous pain relief attempts with ibuprofen and paracetamol. Physical Examination and Recommendations Recommendation: Urgent dispatch of ambulance to assess Mr Smith's condition and administer appropriate pain relief. Arranging Ambulance Service Emergency Response: Details provided to Mr Smith to ensure comfort until ambulance arrival in Stoke-on-Trent (ST16). Final Instructions and Follow-Up Instructions: Mr Smith advised to monitor pain and update emergency services if condition worsens before arrival. Son instructed to assist until help arrives. https://d3imrogdy81qei.cloudfront.net/video_images/8751/Scenario_5_-_Lower_back_pain-01.jpg Yes 301 https://www.protriage.co.uk/training/video/health-and-wellbeing-in-the-triage-workplace https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4883.mp4 Health and Wellbeing in the triage workplace Support for Practitioners Dealing with Distressing Phone Calls in Triage Understanding the Emotional Impact of Triage Calls Mark discusses the emotional challenges of handling distressing phone calls in triage: Types of Calls: Calls involving palliative care and end-of-life situations are particularly impactful. Emotional Burden: Dealing with anxious relatives and discussing emotive subjects can be mentally draining. Available Support for Triage Practitioners Shawn outlines the support options for practitioners: Line Manager Support: Always available for practitioners needing immediate assistance or debriefing. On-Site Supervisors: Accessible within the triage centre to provide downtime and emotional support. Mental Health First-Aiders: Trained individuals with counselling skills available to discuss and assist with emotional challenges. Employee Advisory Programme: Offers formal support including counselling services for those needing additional assistance. It's crucial for practitioners to know they are not alone and support is readily accessible. https://d3imrogdy81qei.cloudfront.net/video_images/8705/Health_and_Wellbeing_in_the_triage_workplace-01.jpg Yes 119 https://www.protriage.co.uk/training/video/initial-impression https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4885.mp4 Initial impression Understanding the Triage Process in Healthcare Initiating Triage: From Waiting Room to Assessment Room Mark explains the initial stages of the triage process: Assessment Beginnings: Triage starts as soon as patient details are reviewed on-screen or from hand-over sheets. Observations: Upon calling the patient, initial observations begin—from their response to their gait and appearance. Assessing Patient Condition Prior to Formal Triage Mark elaborates on pre-assessment insights: Pre-Assessment Evaluation: Observing patients in the waiting room provides vital clues about their condition and urgency. Visual Cues: Sitting position, facial expression, and skin colour offer initial indications of patient well-being. Formal Triage Process in the Assessment Room Discussing the structured triage process upon bringing the patient into the assessment room: A2E Assessment: Assessing Airway, Breathing, Circulation, Neurological disability, and Exposure (A2E) guides immediate priorities. Time Efficiency: A thorough triage ideally takes no longer than 10 minutes, ensuring swift assessment and pathway determination. Communication and Patient Understanding Highlighting the balance between efficiency and patient rapport: Clear Communication: Emphasizing the importance of concise information gathering to direct patients to appropriate care pathways quickly. Patient Comfort: Creating a reassuring environment while expediting the process to initiate necessary healthcare interventions promptly. Ensuring efficient triage is crucial for timely and effective patient care, balancing speed with thorough assessment and patient-centred communication. https://d3imrogdy81qei.cloudfront.net/video_images/8709/Initial_impression-01.jpg Yes 378 https://www.protriage.co.uk/training/video/telephone-triage-scenario-summary- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4906.mp4 Telephone triage - Scenario summary Optimal Approach in Telephone Triage Introduction to Structured Communication Effective Telephone Triage: Following a structured approach ensures thorough patient assessment and optimal care. Key Steps in Telephone Triage Structured Approach: Begin with introduction, gaining consent, and gathering relevant medical history. Patient-Centred Management Patient's Best Interest: Even when patients prefer not to be seen, explaining the benefits of a face-to-face consultation ensures comprehensive care. Ensuring Optimal Outcomes Outcome Focus: Adhering to the structured process protects patient welfare and enhances overall outcomes. https://d3imrogdy81qei.cloudfront.net/video_images/8697/Telephone_triage_-_Scenario_summary-01.jpg Yes 67 https://www.protriage.co.uk/training/video/introduction-to-telephone-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4895.mp4 Introduction to telephone triage Telephone Triage vs Face-to-Face Triage Overview of Differences Shawn asks Mark about the differences between telephone and face-to-face triage: Telephone Triage Skills: Requires advanced practitioner skills including prescribing. Communication Challenges: Relies on verbal cues from the patient. Key Steps in Telephone Triage: Introduce yourself and explain the purpose. Obtain consent and confirm patient details. Gather comprehensive information about the patient's condition. Focus on the main complaint to assess urgency. Discuss treatment options and safety netting. Document thoroughly and ensure patient understanding. Compensating for Non-Verbal Communication Mark discusses compensating for lack of non-verbal cues in telephone triage: Utilizing Support: Engage others in the patient's environment for observations. Encouraging Patient Actions: Direct patients to perform self-assessments or use technology for visuals. Technological Support: Use video conferencing or secure photo sharing for better assessment. Physical Observations: Guide patients to provide auditory or visual clues if possible. Imagination and Differential Diagnoses Mark and Shawn discuss the challenges of imagination and differential diagnoses in telephone triage: Imagination and Assessment: Requires envisioning patient environments and conditions. Comprehensive Assessment: Consider multiple possibilities and ensure thorough assessment. Ensuring Patient Safety: If unsure, arrange for face-to-face consultation for a complete assessment. Telephone triage demands skill and adaptability to effectively assess patients remotely, ensuring safety and appropriate care planning. https://d3imrogdy81qei.cloudfront.net/video_images/8753/Introduction_to_telephone_triage-01.jpg Yes 318 https://www.protriage.co.uk/training/video/chest-pain-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4817.mp4 Chest pain Triage Assessment for Chest Pain - Brenda's Case Introduction Hi, I'm Mark, one of the triage nurses today. Could you please confirm your name and date of birth? Brenda King, 14th June 1975. Understanding Triage Triage is a quick assessment to prioritise your care and ensure you're seen by the right healthcare professional at the right time. Assessment of Symptoms Brenda: Yes, just the left side. It feels like someone has sat on my chest, this heaviness. Mark: How long have you had this pain? Brenda: Started this morning suddenly around 10 o'clock, feels like an elephant on my chest. Mark: Any other symptoms like sweating, nausea? Brenda: Yes, clammy, sweating, bit nauseous. No vomiting. Medical History Mark: Any allergies or current medications? Brenda: No allergies, no current medications. Mark: Previous medical problems? Brenda: High cholesterol, but managing it. Plan and Next Steps Mark: We need to get you to A&E quickly for a heart tracing due to your symptoms and family history. Is that okay? Brenda: Yes, my family has heart problems, hope it's not that. Mark: We'll arrange an ECG and likely take blood for further assessment. Conclusion Mark: I'll call for a wheelchair to take you to triage one for an ECG. They're here now to take you. Brenda: Thank you so much. Mark: You're welcome. Follow the porter, they'll take you straight to A&E. https://d3imrogdy81qei.cloudfront.net/video_images/8585/Chest_pain-01.jpg Yes 210 https://www.protriage.co.uk/training/video/course-summary- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4803.mp4 Course Summary Completing Your Course and Taking the Test with ProTrainings Congratulations on completing your course! Before taking the test, review the student resources section and refresh your skills. Student Resources Section Free student manual: Download your manual and other resources. Additional links: Find helpful websites to support your training. Eight-month access: Revisit the course and view any new videos added. Preparing for the Course Test Before starting the test, you can: Review the videos Read through documents and links in the student resources section Course Test Guidelines No time limit: Take the test at your own pace, but complete it in one sitting. Question format: Choose from four answers or true/false questions. Adaptive testing: Unique questions for each student, with required section passes. Retake option: Review materials and retake the test if needed. After Passing the Test Once you pass the test, you can: Print your completion certificate Print your Certified CPD statement Print the evidence-based learning statement Additional ProTrainings Courses ProTrainings offers: Over 350 courses at regional training centres or your workplace Remote virtual courses with live instructors Over 300 video online and blended courses Contact us at 01206 805359 or email support@protrainings.uk for assistance or group training solutions. Thank you for choosing ProTrainings and good luck with your test! https://d3imrogdy81qei.cloudfront.net/video_images/8553/Course_Summary-01.jpg Yes 127 https://www.protriage.co.uk/training/video/the-ten-second-triage-tool https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6110.mp4 The Ten Second Triage Tool The Ten Second Triage Tool: Revolutionising Patient Triage in the NHS Introduction to The Ten Second Triage Tool The NHS is committed to enhancing patient care through innovation, and the latest breakthrough comes in the form of The Ten Second Triage Tool: Simplifying Triage with Unprecedented Speed With its revolutionary digital solution, The Ten Second Triage Tool significantly streamlines the triage process: Rapid Assessment: As the name suggests, it only takes 10 seconds to complete an initial assessment, offering unparalleled speed without compromising accuracy. Artificial Intelligence-driven: The tool utilizes sophisticated AI algorithms to assess the severity of patient symptoms in real-time, providing guidance on the most appropriate care pathway. User-Friendly Interface: The tool's intuitive design makes it accessible to individuals of all ages and technical proficiencies, reducing congestion in waiting rooms and ensuring a safer patient journey. Benefits and Impact on Patient Care The Ten Second Triage Tool offers several key benefits that contribute to enhancing patient care: Reduced Waiting Times: By expediting the triage process, patients experience faster treatment, particularly crucial in emergency situations where every second counts. Standardised Approach: The tool's AI-driven decision-making process eliminates potential biases or inconsistencies, ensuring fair treatment for all patients, regardless of the healthcare professional conducting the triage. Effective Resource Allocation: The tool allows healthcare professionals to allocate resources more effectively by quickly assessing patients' needs, resulting in better resource management and improved patient outcomes. Understanding the Tool's Role It is important to note that The Ten Second Triage Tool does not replace the expertise of qualified healthcare professionals. Instead, it serves as an aid to support their decision-making process. Continued research and refinement of the tool's AI algorithms will be crucial to ensure its long-term success and accuracy. With its potential to transform patient triage, The Ten Second Triage Tool represents the future of healthcare innovation in the NHS, combining technology and care to create effective, efficient, fair, and patient-centered solutions. https://d3imrogdy81qei.cloudfront.net/video_images/10876/Triage.jpg Yes 205 https://www.protriage.co.uk/training/video/using-the-ten-second-triage-tool https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6111.mp4 Using The Ten Second Triage Tool The Ten Second Triage Tool: Streamlining Incident Triage Introduction to The Ten Second Triage Tool The Ten Second Triage Tool is a powerful resource that provides recommendations for prioritising triage pathways based on incident specifics: Simplifying Triage Decisions With its straightforward question-based approach, the tool quickly determines the urgency of each incident: Clear Pathways: Each pathway is assigned based on simple yes or no answers, ensuring efficient prioritisation. Identifying Urgency: The tool categorises incidents into P1, P2, or P3, indicating levels of urgency, along with unfortunate cases of fatalities. Emphasising Key Instructions: Important medical instructions are highlighted in bold, ensuring vital measures are not overlooked. Pathway Determination Examples Let's explore some examples of how the Ten Second Triage Tool determines appropriate pathways: Walking Ability: If the patient can walk, the tool assigns a P3 level of urgency. Severe Bleeding: For cases of severe bleeding, measures like pressure application, tourniquet use, and packing are recommended, signifying a P1 priority. Verbal Communication: If the patient can communicate verbally, further questions are asked to determine the level of urgency. Breathing Capability: The ability to breathe is assessed, with appropriate actions taken based on the response, such as opening the airway or initiating CPR. The Methane Model for Incident Management The Ten Second Triage Tool also utilises the methane model to bring order and clarity to incident management: M: Major incident declaration E: Exact location of the incident T: Type of incident H: Hazardous conditions present A: Access routes to the incident N: Number of casualties involved E: Emergency services needed or present on site Enhanced Data Collection The tool allows for the recording of additional information, such as patient counts in each priority category and the number of non-breathing patients. For more detailed information on how to use the Ten Second Triage Tool, please refer to the student download. https://d3imrogdy81qei.cloudfront.net/video_images/10874/Using_The_Ten_Second_Triage_Tool-01.jpg Yes 133 https://www.protriage.co.uk/training/video/abdominal-pain https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4827.mp4 Abdominal pain Triage Assessment for Gallstones: Patient Care Protocol Introduction to Triage Assessment Hi, my name is Mark and I'm one of the triage nurses here today. Before we proceed, could you please confirm your name and date of birth? Brenda King, 17th June 1974. Excellent, thank you. Triage is a brief assessment to ensure you see the right healthcare professional promptly. Initial Vital Signs Check Let's start with your blood pressure. Is it okay to use your left arm? No issues with that. We'll also take your temperature. Now, what symptoms have you been experiencing? Pain in my upper abdomen, radiating to my back. It worsens after eating, although I'm improving my diet. It comes in waves and is quite intense. Medical History and Symptoms I understand you've been diagnosed with gallstones. How would you describe the pain? It's a spasming, cramping type of pain. Any other medical issues or regular medications? No other medical problems. I take Co-codamol for the pain, but it only takes the edge off. Assessment and Next Steps Have you noticed any other symptoms like blood in vomit or changes in urine or bowels? No blood in vomit, and no changes in urine or bowels. Based on your symptoms, we'll arrange for you to see a GP. They'll examine you and plan your treatment. Conclusion Do you need any pain relief right now? I'm okay for now as I took some medication an hour ago. Let's get you to the GP. Follow the corridor out the door, take the third right, then left to the end of the corridor. Thank you. https://d3imrogdy81qei.cloudfront.net/video_images/8609/Abdominal_pain-01.jpg Yes 218 https://www.protriage.co.uk/training/video/allergy- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4819.mp4 Allergy Rash Assessment in A&E Introduction Hi, my name is Mark and I'll be conducting your triage today. Let's start by confirming your details. Patient Details Confirmation Could you please confirm your name and date of birth? Brenda King: 14th June 1984 Reason for Visit What brings you to A&E today, Brenda? Brenda: Well, I've developed a rash all over my body that's very itchy. I noticed it about two days ago after changing my fabric softener, but creams from the pharmacy haven't helped. Initial Assessment Let's start by taking your blood pressure while we continue our discussion. Brenda: Sure. Rash Description Is the rash widespread or localized? Brenda: It's all over, mainly where my clothes end - torso and legs. Vital Signs Check We'll also check your temperature. Brenda's Temperature: Normal Additional Symptoms Have you experienced any other symptoms? Brenda: No, just the discomfort and self-consciousness from the rash. Specific Queries Any shortness of breath or swelling in the mouth or abdomen? Brenda: No, none of that. Medical History and Medication Do you have any existing medical conditions or allergies? Brenda: No, I'm generally healthy and not on any medication. Physical Examination I'll listen to your breathing and check your pulse. Brenda: Okay. Recent Actions Have you taken any medication like antihistamines? Brenda: Tried Piriton, but it didn't fully alleviate the rash. Conclusion and Next Steps We'll arrange for you to see a GP at the urgent care centre for a thorough examination. Brenda: Okay, thank you. Mark: If anything changes before you see the doctor, please let someone know. Brenda: Understood. Head out the door, left down the path, and you'll find the urgent care centre. Brenda: Thank you. Mark: You're welcome. https://d3imrogdy81qei.cloudfront.net/video_images/8589/Allergy-01.jpg Yes 249 https://www.protriage.co.uk/training/video/testicular-pain https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4828.mp4 Testicular pain Assessment of Testicular Pain in Triage: Urgent Care Guidelines Introduction Hello, I'm Lutena, one of the triage nurses here. We'll do a quick assessment to direct you to the appropriate care. Could you please confirm your date of birth for me? Date of Birth: 15th June 1970 Name: Brendon King Chief Complaint Chief Complaint: Testicular Pain Brendon, can you tell me more about the pain in your testicle? Location: Right testicle Nature of Pain: Throbbing, aching pain, worsened upon standing up Pain Score: Around nine out of ten Medical History and Current Symptoms Have you taken any painkillers for this? Pain Relief: Co-codamol, which has slightly alleviated the pain but still very uncomfortable Any changes in urination? Urination: Normal, no blood observed Assessment and Plan Next Steps: We will expedite your assessment in A&E to address the severe testicular pain. A clinician will conduct a thorough examination and determine the necessary treatment. When you leave this room, head left and follow the corridor to the Assessment area. Please wait there, and they will call you in promptly. Instructions: Sit in the Assessment area and await further instructions. Thank you, Brendon. https://d3imrogdy81qei.cloudfront.net/video_images/8611/Testicular_pain-01.jpg Yes 139 https://www.protriage.co.uk/training/phonetriage/video/using-the-ten-second-triage-tool https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6111.mp4 Using The Ten Second Triage Tool The Ten Second Triage Tool: Streamlining Incident Triage Introduction to The Ten Second Triage Tool The Ten Second Triage Tool is a powerful resource that provides recommendations for prioritising triage pathways based on incident specifics: Simplifying Triage Decisions With its straightforward question-based approach, the tool quickly determines the urgency of each incident: Clear Pathways: Each pathway is assigned based on simple yes or no answers, ensuring efficient prioritisation. Identifying Urgency: The tool categorises incidents into P1, P2, or P3, indicating levels of urgency, along with unfortunate cases of fatalities. Emphasising Key Instructions: Important medical instructions are highlighted in bold, ensuring vital measures are not overlooked. Pathway Determination Examples Let's explore some examples of how the Ten Second Triage Tool determines appropriate pathways: Walking Ability: If the patient can walk, the tool assigns a P3 level of urgency. Severe Bleeding: For cases of severe bleeding, measures like pressure application, tourniquet use, and packing are recommended, signifying a P1 priority. Verbal Communication: If the patient can communicate verbally, further questions are asked to determine the level of urgency. Breathing Capability: The ability to breathe is assessed, with appropriate actions taken based on the response, such as opening the airway or initiating CPR. The Methane Model for Incident Management The Ten Second Triage Tool also utilises the methane model to bring order and clarity to incident management: M: Major incident declaration E: Exact location of the incident T: Type of incident H: Hazardous conditions present A: Access routes to the incident N: Number of casualties involved E: Emergency services needed or present on site Enhanced Data Collection The tool allows for the recording of additional information, such as patient counts in each priority category and the number of non-breathing patients. For more detailed information on how to use the Ten Second Triage Tool, please refer to the student download. https://d3imrogdy81qei.cloudfront.net/video_images/10874/Using_The_Ten_Second_Triage_Tool-01.jpg Yes 133 https://www.protriage.co.uk/training/phonetriage/video/the-ten-second-triage-tool https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6110.mp4 The Ten Second Triage Tool The Ten Second Triage Tool: Revolutionising Patient Triage in the NHS Introduction to The Ten Second Triage Tool The NHS is committed to enhancing patient care through innovation, and the latest breakthrough comes in the form of The Ten Second Triage Tool: Simplifying Triage with Unprecedented Speed With its revolutionary digital solution, The Ten Second Triage Tool significantly streamlines the triage process: Rapid Assessment: As the name suggests, it only takes 10 seconds to complete an initial assessment, offering unparalleled speed without compromising accuracy. Artificial Intelligence-driven: The tool utilizes sophisticated AI algorithms to assess the severity of patient symptoms in real-time, providing guidance on the most appropriate care pathway. User-Friendly Interface: The tool's intuitive design makes it accessible to individuals of all ages and technical proficiencies, reducing congestion in waiting rooms and ensuring a safer patient journey. Benefits and Impact on Patient Care The Ten Second Triage Tool offers several key benefits that contribute to enhancing patient care: Reduced Waiting Times: By expediting the triage process, patients experience faster treatment, particularly crucial in emergency situations where every second counts. Standardised Approach: The tool's AI-driven decision-making process eliminates potential biases or inconsistencies, ensuring fair treatment for all patients, regardless of the healthcare professional conducting the triage. Effective Resource Allocation: The tool allows healthcare professionals to allocate resources more effectively by quickly assessing patients' needs, resulting in better resource management and improved patient outcomes. Understanding the Tool's Role It is important to note that The Ten Second Triage Tool does not replace the expertise of qualified healthcare professionals. Instead, it serves as an aid to support their decision-making process. Continued research and refinement of the tool's AI algorithms will be crucial to ensure its long-term success and accuracy. With its potential to transform patient triage, The Ten Second Triage Tool represents the future of healthcare innovation in the NHS, combining technology and care to create effective, efficient, fair, and patient-centered solutions. https://d3imrogdy81qei.cloudfront.net/video_images/10876/Triage.jpg Yes 205 https://www.protriage.co.uk/training/phonetriage/video/abcde-and-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4869.mp4 ABCDE and triage Understanding the ABCDE System in Triage Overview of the ABCDE System Explaining the components of the ABCDE system used in triage: A - Airway: Ensuring the patient has a clear airway to breathe properly. This is critical in cases of throat swelling or choking. B - Breathing: Assessing if the patient can speak in full sentences and if their breathing is symmetrical and adequate. C - Circulation: Checking the pulse, skin colour, and overall perfusion to determine circulation status. D - Disability: Evaluating neurological function to understand the patient's awareness and responsiveness using scales like AVPU. E - Exposure: Examining the patient for any visible issues such as injuries or signs of distress. Importance of ABCDE in Triage Discussing the significance of the ABCDE assessment in triage: Constant Assessment: The ABCDE system is continuously in the triage nurse's mind, guiding the assessment process. Quick and Effective: It provides a rapid yet comprehensive method to evaluate and prioritize patient care needs. These ABCDE findings form the basis of critical decisions in triage, influencing patient management and pathway determination. https://d3imrogdy81qei.cloudfront.net/video_images/8691/ABCDE_and_triage-01.jpg Yes 156 https://www.protriage.co.uk/training/phonetriage/video/assessing-pain https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4874.mp4 Assessing pain Pain Assessment Techniques: Understanding and Application Objective vs. Subjective Pain Assessment Pain, a subjective sensation experienced by individuals, becomes objective when assessed by clinicians. Various pain assessment tools aid in this process, including the pain ladder and pain smiley faces. Pain Severity Scale: Typically measured on a scale of 0 to 10 Some variations: 0 to 3 or 0 to 5 Focus on Pain Quality: Triaging clinicians prioritize identifying the type of pain (sharp, dull, spasmodic, crampy) and its characteristics (radiation) over solely assessing severity. PQRST Mnemonic: P - Provocative and Palliative: What worsens or alleviates the pain? Q - Quality: Describing the nature of the pain (sharp, dull) R - Radiation: Any pain spreading to other areas? S - Severity: Numeric scale assessment T - Timing: When did the pain begin? Smiley Faces Technique: Originally designed for children but applicable to adults, this technique utilises smiley faces corresponding to numerical pain values (0 to 10). Patients select a face that best represents their pain level, aiding in accurate assessment. Conclusion Understanding and employing various pain assessment techniques, such as the PQRST mnemonic and smiley faces, enhances clinical evaluation, leading to effective pain management. https://d3imrogdy81qei.cloudfront.net/video_images/8719/Assessing_pain-01.jpg Yes 185 https://www.protriage.co.uk/training/phonetriage/video/analgesia-in-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4871.mp4 Analgesia in triage Options for Pain Relief in Triage: Tools and Techniques Overview of Pain Relief Options Exploring the tools and methods available for pain relief in triage: Patient Group Directive: Triage staff are trained to administer paracetamol or ibuprofen under this directive, streamlining pain relief without needing a prescription. Considerations: Before administering medication, it's crucial to assess risks such as previous medication use and existing health conditions like stomach ulcers. Importance of History Taking: Gathering detailed patient history helps in making informed decisions about appropriate pain relief. Advanced Pain Relief Options Options beyond basic medications available through triage: Intravenous Pain Relief: Patients may receive stronger medications like morphine via IV once they are on the appropriate care pathway. Pathway Prioritization: Initiating the correct pathway ensures timely access to more potent pain relief options as needed. Alternative Pain Management Techniques Non-medication strategies to alleviate pain: Positional and Comfort Measures: Techniques such as using arm slings for fractures or elevating limbs can provide significant relief. Psychological Support: Reassurance and supportive communication can have a placebo effect, positively impacting patient comfort. These methods aim to address pain effectively while considering individual patient needs and conditions. https://d3imrogdy81qei.cloudfront.net/video_images/8717/Analgesia_in_triage-01.jpg Yes 172 https://www.protriage.co.uk/training/phonetriage/video/establishing-patient-presentations https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4880.mp4 Establishing patient presentations Establishing Patient Complaints: Tips and Strategies in Triage Understanding the Patient's Complaint Exploring effective methods to uncover and understand the patient's narrative: Key Information Gathering: Start by learning what happened, when it occurred, and its severity. Assess injuries directly if visible under bandages or plasters to check for bleeding, infection, or deformity. Non-Verbal Communication: Recognise the significance of non-verbal cues, especially helpful when language barriers exist. Encourage patients to point to areas of discomfort or use tools like Language Line for interpreters. Challenges with Dementia Patients Addressing specific challenges and solutions when dealing with dementia patients: Importance of Accompanying Carers: Patients with dementia benefit greatly when accompanied by a family member or carer who understands their condition. Role of the Carer: Carers often act as interpreters, providing valuable insights into the patient's needs and aiding in effective communication and care decisions. Utilising these strategies ensures thorough understanding and effective communication in triage settings, enhancing patient care and satisfaction. https://d3imrogdy81qei.cloudfront.net/video_images/8723/Establishing_patient_presentations-01.jpg Yes 123 https://www.protriage.co.uk/training/phonetriage/video/establishing-patient-history https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4881.mp4 Establishing patient history Establishing Patient History in Triage: Tips and Techniques Importance of Patient History Understanding how to effectively gather and assess patient history in a triage setting: Identifying Chronic Illnesses: Patients often present with known medical conditions that may worsen (acute-on-chronic). Focus on what has changed and why they are seeking care today. Relevance and Conciseness: Avoid delving too far into historical details that are not pertinent to the current visit. Concentrate on changes in symptoms and their relevance to the current complaint. Strategies for Effective History Taking Practical tips for maintaining focus and relevance during patient history assessment: Body Language Awareness: Use non-verbal cues to guide the conversation and keep it focused on the presenting issue. Active Triage Management: Maintain control of the triage process by steering the conversation towards relevant information without unnecessary diversions. Clear Communication: Emphasize the importance of concise and accurate information from the patient to facilitate efficient triage. By following these guidelines, healthcare professionals can ensure a thorough yet focused assessment of patient history, leading to appropriate triage decisions and efficient patient care. https://d3imrogdy81qei.cloudfront.net/video_images/8727/Establishing_patient_history-01.jpg Yes 199 https://www.protriage.co.uk/training/phonetriage/video/existing-medications https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4882.mp4 Existing medications Managing Existing Medication in Triage: Importance and Considerations Understanding the Impact of Existing Medication Exploring the significance of existing medication and its implications in the triage process: Effect on Vital Signs: Medication can alter physiological responses, such as artificially lowering blood pressure or pulse rates, which may obscure the true condition of the patient. Patient Awareness: There's often a disconnect where patients may not fully understand their medications or their purposes, posing challenges during assessment. Challenges and Considerations Addressing common issues and considerations when managing medication in triage: Overdosing Concerns: Monitoring for unintentional overdoses, such as with paracetamol or combinations like paracetamol with co-codamol, is crucial due to potential cumulative effects. Alternative Therapies: Herbal remedies and cultural practices should also be noted as they can impact treatment decisions and patient outcomes. Substance Use: Approach with sensitivity when discussing illegal drugs or CBD usage, as patients may not disclose due to legal concerns, necessitating careful clinical judgment. Documentation in triage notes ensures accurate recording of factual information provided by the patient. https://d3imrogdy81qei.cloudfront.net/video_images/8731/Existing_medications-01.jpg Yes 245 https://www.protriage.co.uk/training/phonetriage/video/mental-health-and-telephone-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4887.mp4 Mental health and telephone triage Triage Strategies for Patients with Mental Health Issues Challenges of Triage in Mental Health Cases Addressing the complexities of triaging patients with mental health concerns: High Workload Impact: Mental health crises often constitute a significant portion of out-of-hours triage demands. Communication Difficulties: Patients may struggle to articulate their condition or may resist speaking during consultations. Effective Approaches in Triage Strategies to manage and support mental health patients during triage: Empathetic Approach: Treat every mental health patient with compassion and patience, ensuring they feel heard and understood. Risk Assessment: Assess the immediate risk of self-harm or suicidal ideation through careful questioning about intentions and plans. Utilizing Available Information: Gather details about current medications and their dosages to gauge the patient's condition management. Escalation Protocols: If there is a perceived risk of harm and communication abruptly stops, escalate the case to emergency services, potentially involving ambulance and police services. Following such incidents, ensure thorough documentation and appropriate referrals to safeguarding boards for vulnerable adult protection. https://d3imrogdy81qei.cloudfront.net/video_images/8733/Mental_health_and_telephone_triage-01.jpg Yes 166 https://www.protriage.co.uk/training/phonetriage/video/news2-and-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4890.mp4 NEWS2 and triage Understanding the NEWS2 System in Triage Overview of NEWS2 in Triage Exploring the role of the National Early Warning Score (NEWS2) in rapid assessment and triage: Diagnostic Role: NEWS2 involves gathering vital signs like blood pressure, temperature, etc., to calculate a predictive score. Predictive Function: NEWS2 predicts the patient's acuity and guides the level of care they require based on their current condition. Components of the NEWS2 Score Understanding the physiological parameters included in the NEWS2 score: Key Parameters: Includes respiratory rate, pulse rate, pulse oximetry, conscious level, blood pressure, and pain scores. Significance of Parameters: Each parameter's abnormality contributes to an overall score, indicating the patient's risk of deterioration. Interpreting NEWS2 Scores Guidelines for interpreting NEWS2 scores and their implications: Severity Levels: A score of 5 or above indicates a need for urgent intervention and higher dependency care. Immediate Action: Individual parameter scores of 3 highlight specific concerns requiring urgent assessment and intervention. Utilizing NEWS2 helps in early identification of patients at risk of deterioration, facilitating prompt and appropriate medical intervention. https://d3imrogdy81qei.cloudfront.net/video_images/8735/NEWS2_and_triage-01.jpg Yes 152 https://www.protriage.co.uk/training/phonetriage/video/professional-considerations https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4905.mp4 Professional considerations Recording Triage Encounters and Documentation Guidelines Importance of Recording Telephone Triage When conducting triage over the phone, it's crucial to understand the implications of recording conversations: Benefit of Recording: Recorded conversations serve as valuable support in case your notes or decisions are questioned. Documentation Equivalence: Notes from telephone triage should mirror those from face-to-face encounters, documenting comprehensive and relevant information. Safeguarding and Ethical Considerations It's essential to handle sensitive information and ethical concerns appropriately: Child Protection: Any indication of child endangerment must be documented and reported through your organisation's incident reporting system, potentially involving the police during out-of-hours periods. Vulnerable Adults: Incidents involving vulnerable adults should be reported to local safeguarding boards to ensure their protection. Ethical Practices with Palliative Patients: For patients in palliative care, gather comprehensive information including do-not-attempt-CPR plans, ReSPECT paperwork, and advanced care plans. Discuss these details with the family to inform decision-making processes. By adhering to these guidelines, you ensure thorough documentation and ethical practice in telephone triage scenarios. https://d3imrogdy81qei.cloudfront.net/video_images/8741/Professional_considerations-01.jpg Yes 150 https://www.protriage.co.uk/training/phonetriage/video/computer-based-telephone-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4898.mp4 Computer-based telephone triage Telephone Triage Process and Documentation Introduction to Telephone Triage Exploring the process of conducting telephone triage using the Adastra platform: Platform Overview: Adastra platform facilitates remote consultations akin to face-to-face assessments. Patient Verification: Confirming patient identity by verifying name and date of birth before documentation to ensure accuracy. Establishing Rapport: Introducing oneself and clarifying roles within the organisation to enhance patient comfort and cooperation. Components of Consultation Documentation Understanding the elements covered during the telephone triage consultation: History Collection: Gathering information on presenting complaints, medical history, medications, allergies, and social circumstances. Treatment Discussion: Documenting advice given, including self-care recommendations, medication instructions, and safety precautions. Safety Netting: Highlighting follow-up instructions such as monitoring symptoms and recognizing red flag warning signs. Concluding the Consultation Final steps to conclude and ensure patient understanding and agreement: Confirmation of Plan: Ensuring the patient comprehends and consents to the outlined plan before closing the consultation. Prescription Handling: Directing prescriptions either electronically or to a preferred pharmacy, considering out-of-hours arrangements. Case Closure: Reviewing and finalizing consultation notes before categorizing the case as self-care, clinic visit, or home visit. Implementing thorough documentation and clear communication in telephone triage ensures effective patient management and continuity of care. https://d3imrogdy81qei.cloudfront.net/video_images/8739/Computer-based_telephone_triage-01.jpg Yes 263 https://www.protriage.co.uk/training/phonetriage/video/course-summary- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4803.mp4 Course Summary Completing Your Course and Taking the Test with ProTrainings Congratulations on completing your course! Before taking the test, review the student resources section and refresh your skills. Student Resources Section Free student manual: Download your manual and other resources. Additional links: Find helpful websites to support your training. Eight-month access: Revisit the course and view any new videos added. Preparing for the Course Test Before starting the test, you can: Review the videos Read through documents and links in the student resources section Course Test Guidelines No time limit: Take the test at your own pace, but complete it in one sitting. Question format: Choose from four answers or true/false questions. Adaptive testing: Unique questions for each student, with required section passes. Retake option: Review materials and retake the test if needed. After Passing the Test Once you pass the test, you can: Print your completion certificate Print your Certified CPD statement Print the evidence-based learning statement Additional ProTrainings Courses ProTrainings offers: Over 350 courses at regional training centres or your workplace Remote virtual courses with live instructors Over 300 video online and blended courses Contact us at 01206 805359 or email support@protrainings.uk for assistance or group training solutions. Thank you for choosing ProTrainings and good luck with your test! https://d3imrogdy81qei.cloudfront.net/video_images/8553/Course_Summary-01.jpg Yes 127 https://www.protriage.co.uk/training/phonetriage/video/electronic-patient-records https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4877.mp4 Electronic patient records Recording Triage Episodes on Computer: Step-by-Step Guide Introduction to Triage Recording Mark and Shawn discuss the process of recording triage episodes electronically: Initial Steps: Introduce yourself to the patient, take physical observations, and gather history of complaints. Accessing Triage Details Tab: Navigate to the triage details section on the computer system. Data Entry: Enter date, time, and personal details followed by patient's physical observations. Entering Vital Signs Shawn demonstrates entering vital signs into the computer: Example 1 - Stable Patient: Respiratory rate 16, oxygen saturation 98%, temperature 36.8°C, systolic blood pressure 124, heart rate 68, pain score 2, alertness. Example 2 - Acutely Unwell Patient: Respiratory rate 38, oxygen saturation 91%, temperature 36.6°C, systolic blood pressure 120, heart rate 38, pain score 0. Automatic Calculation of NEWS Score Mark learns about the automated calculation of NEWS score based on vital signs: NEWS 2 Calculation: The computer computes the NEWS score automatically from entered vital signs. Example of Acute Illness: High NEWS score indicates severe condition prompting immediate action to transfer to resuscitation area. Understanding and correctly entering triage data ensures efficient patient management and appropriate medical response. https://d3imrogdy81qei.cloudfront.net/video_images/8701/Electronic_patient_records-01.jpg Yes 213 https://www.protriage.co.uk/training/phonetriage/video/the-goal-of-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4896.mp4 The goal of triage Understanding Triage and Patient Pathways in NHS Purpose of Triage Mark and Shawn discuss the fundamental aspects of triage: Definition of Triage: Derived from French, meaning 'to sort', it involves assessing and prioritising patients based on severity. Sorting Severity: Determines how quickly patients need to be seen and directs them to appropriate care pathways. Understanding Patient Pathways Mark explains the concept of pathways within the NHS: Definition of Pathway: Refers to the journey a patient takes through healthcare services based on their condition and needs. A&E Pathway Example: Patients proceed from triage to appropriate areas like minor injury units, doctor consultations, investigations, and discharge or admission. Pathway Flexibility: Tailored to the severity and nature of the illness or injury assessed during triage. Ensuring Patient Well-being and Completion of Treatment Shawn highlights the objective of initiating and completing patient care journeys: Starting the Journey: Begins with baseline observations and triage assessment. Completing the Journey: Aims for patients to leave hospital treated and fit, or admitted for further definitive care. Understanding these processes ensures efficient and effective patient management within NHS emergency departments. https://d3imrogdy81qei.cloudfront.net/video_images/8699/The_goal_of_triage-01.jpg Yes 91 https://www.protriage.co.uk/training/phonetriage/video/discriminators https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4878.mp4 Discriminators Triage Process: Handling Patients with Ankle Injury and Urinary Symptoms Introduction to Triage Assessment Mark and Shawn discuss how to triage patients presenting with different conditions: Ankle Injury Scenario: Patient reports non-weight bearing and severe pain. Urinary Symptoms Scenario: Patient complains of pain while passing urine. Handling an Ankle Injury Shawn explains the process of triaging a patient with an ankle injury: Selecting Categories: Choose 'Trauma, Musculoskeletal' and specify 'Ankle' under presenting complaint. Pain Assessment: Patient reports pain as 10 out of 10, indicating 'Significant Pain'. Triage Category: Categorize as 'Very Urgent' for immediate assessment and possible IV analgesia. Pathway Selection: Direct patient to majors area for treatment. Managing Urinary Symptoms Discussing the triage approach for patients with urinary issues: Selecting Categories: Choose 'Triage, Illness' and specify 'Genitourinary Symptoms'. Pain Assessment: Patient reports pain as 4 out of 10, categorizing as 'Urgent'. Triage Category: Determine urgency based on symptoms like difficulty passing urine. Pathway Selection: Determine appropriate treatment area based on triage assessment. Understanding these steps ensures accurate triage categorization and timely patient care. https://d3imrogdy81qei.cloudfront.net/video_images/8703/Discriminators-01.jpg Yes 206 https://www.protriage.co.uk/training/phonetriage/video/how-do-we-triage-correctly https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4884.mp4 How do we triage correctly Importance of Correct Triage Process in Healthcare Understanding Triage and Its Purpose Mark explains the fundamental aspects of triage: Initial Assessment: Triage ensures patients are swiftly placed on the appropriate treatment pathway for quick intervention and definitive care. National Early Warning Score (NEWS): Vital signs are input into the system to compute a NEWS score, indicating the severity of a patient's condition based on various metrics like blood pressure, pulse, and oxygen saturation. Pathway Adherence: Following established pathways is crucial, but flexibility may be needed based on patient assessment. Flexibility in Triage and Pathway Adherence Mark discusses the balance between following protocol and clinical judgment: Deviation from Protocol: Sometimes clinical judgment may necessitate deviation from the standard pathway, prioritizing patient needs over protocol adherence. Safeguards and Documentation: Use of system alerts and narrative notes ensures concerns are flagged for priority care and documented appropriately. Consulting and Collaborating for Safe Decisions Exploring additional options for handling complex cases: System Alerts: Utilize the triage system's alert feature (e.g., stethoscope icon) to notify doctors and nurses of urgent cases. Narrative Documentation: Detailed free-text notes provide a comprehensive overview of prioritized findings. Consulting Peers: Engage with healthcare professionals, including doctors and nurses, for second opinions and collaborative decision-making. Ensuring patient safety and optimal care through informed decisions and collaborative practices remains paramount in triage. https://d3imrogdy81qei.cloudfront.net/video_images/8707/How_do_we_triage_correctly-01.jpg Yes 232 https://www.protriage.co.uk/training/phonetriage/video/health-and-wellbeing-in-the-triage-workplace https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4883.mp4 Health and Wellbeing in the triage workplace Support for Practitioners Dealing with Distressing Phone Calls in Triage Understanding the Emotional Impact of Triage Calls Mark discusses the emotional challenges of handling distressing phone calls in triage: Types of Calls: Calls involving palliative care and end-of-life situations are particularly impactful. Emotional Burden: Dealing with anxious relatives and discussing emotive subjects can be mentally draining. Available Support for Triage Practitioners Shawn outlines the support options for practitioners: Line Manager Support: Always available for practitioners needing immediate assistance or debriefing. On-Site Supervisors: Accessible within the triage centre to provide downtime and emotional support. Mental Health First-Aiders: Trained individuals with counselling skills available to discuss and assist with emotional challenges. Employee Advisory Programme: Offers formal support including counselling services for those needing additional assistance. It's crucial for practitioners to know they are not alone and support is readily accessible. https://d3imrogdy81qei.cloudfront.net/video_images/8705/Health_and_Wellbeing_in_the_triage_workplace-01.jpg Yes 119 https://www.protriage.co.uk/training/phonetriage/video/initial-impression https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4885.mp4 Initial impression Understanding the Triage Process in Healthcare Initiating Triage: From Waiting Room to Assessment Room Mark explains the initial stages of the triage process: Assessment Beginnings: Triage starts as soon as patient details are reviewed on-screen or from hand-over sheets. Observations: Upon calling the patient, initial observations begin—from their response to their gait and appearance. Assessing Patient Condition Prior to Formal Triage Mark elaborates on pre-assessment insights: Pre-Assessment Evaluation: Observing patients in the waiting room provides vital clues about their condition and urgency. Visual Cues: Sitting position, facial expression, and skin colour offer initial indications of patient well-being. Formal Triage Process in the Assessment Room Discussing the structured triage process upon bringing the patient into the assessment room: A2E Assessment: Assessing Airway, Breathing, Circulation, Neurological disability, and Exposure (A2E) guides immediate priorities. Time Efficiency: A thorough triage ideally takes no longer than 10 minutes, ensuring swift assessment and pathway determination. Communication and Patient Understanding Highlighting the balance between efficiency and patient rapport: Clear Communication: Emphasizing the importance of concise information gathering to direct patients to appropriate care pathways quickly. Patient Comfort: Creating a reassuring environment while expediting the process to initiate necessary healthcare interventions promptly. Ensuring efficient triage is crucial for timely and effective patient care, balancing speed with thorough assessment and patient-centred communication. https://d3imrogdy81qei.cloudfront.net/video_images/8709/Initial_impression-01.jpg Yes 378 https://www.protriage.co.uk/training/phonetriage/video/tonsillitis https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4899.mp4 Scenario 1 - Tonsillitis Telephone Consultation for Sore Throat: Guidance and Treatment Introduction Initial Contact: Mr. Smith, a patient, contacts the out-of-hours service with throat concerns. Verification of Patient Details Confirmation: Urgent care practitioner verifies Mr. Smith's identity and reason for calling. Symptoms Assessment Presenting Symptoms: Mr. Smith reports severe throat pain exacerbated by swallowing, along with joint ache and swollen glands under his jawline. Medical History and Current Condition Medical Background: No significant medical history except hay fever, no current medications other than paracetamol. Diagnosis and Treatment Plan Possible Diagnosis: Suspected acute tonsillitis based on symptoms and visual inspection. Treatment Plan: Prescribing a 10-day course of penicillin-based antibiotics. Guidance for Mr. Smith Medication Instructions: Take antibiotics as prescribed, spaced from meals for optimal absorption. Supportive Care: Continue using paracetamol for pain relief, ensure adequate fluid intake. Monitoring: Watch for worsening symptoms such as severe throat pain, difficulty swallowing, or breathing problems. Emergency Protocol: In case of emergency (severe symptoms), dial 999 immediately. Follow-up: If symptoms persist after 2-3 days or worsen, contact GP for review. Conclusion of Call Closure: End of consultation with instructions reiterated and patient understanding confirmed. https://d3imrogdy81qei.cloudfront.net/video_images/8745/Scenario_1_-_Tonsillitis-01.jpg Yes 432 https://www.protriage.co.uk/training/phonetriage/video/awkward-patient-and-antibiotics https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4902.mp4 Scenario 4 - Awkward patient and antibiotics Urgent Care Call with Mr Smith: Ear Infection Assessment Introduction and Identification Introduction: Shawn, an Urgent Care practitioner, contacts Mr Smith regarding his ongoing ear issue. Assessment of Current Condition Current Symptoms: Mr Smith expresses frustration with his ear infection and the ineffectiveness of previous treatments. Medical History and Treatment Medical Background: Discussion on previous antibiotics and pain relief medications taken by Mr Smith. Physical Examination and Next Steps Recommendation: Urgent referral to the Royal Stoke Hospital Urgent Care Centre for a thorough examination and appropriate treatment. Arranging the Urgent Care Appointment Appointment: Details provided for Mr Smith to attend the Royal Stoke Hospital Urgent Care Centre for assessment. Final Instructions and Follow-Up Instructions: Mr Smith advised to await a call for appointment details and contact 111 in case of worsening symptoms or changes before the appointment. https://d3imrogdy81qei.cloudfront.net/video_images/8749/Scenario_4_-_Awkward_patient_and_antibiotics-01.jpg Yes 483 https://www.protriage.co.uk/training/phonetriage/video/telephone-triage-scenario-summary- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4906.mp4 Telephone triage - Scenario summary Optimal Approach in Telephone Triage Introduction to Structured Communication Effective Telephone Triage: Following a structured approach ensures thorough patient assessment and optimal care. Key Steps in Telephone Triage Structured Approach: Begin with introduction, gaining consent, and gathering relevant medical history. Patient-Centred Management Patient's Best Interest: Even when patients prefer not to be seen, explaining the benefits of a face-to-face consultation ensures comprehensive care. Ensuring Optimal Outcomes Outcome Focus: Adhering to the structured process protects patient welfare and enhances overall outcomes. https://d3imrogdy81qei.cloudfront.net/video_images/8697/Telephone_triage_-_Scenario_summary-01.jpg Yes 67 https://www.protriage.co.uk/training/phonetriage/video/chest-pain https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4900.mp4 Scenario 2 - Chest pain Emergency Call for Mrs Smith: Urgent Hospital Referral Initial Contact Introduction: Urgent care practitioner contacts Mr Smith regarding Mrs Smith's health concerns. Assessment of Mrs Smith's Condition Condition: Mrs Smith is unable to speak due to severe pain and difficulty breathing, with ongoing chest pain throughout the day. Medical History and Current Symptoms Medical Background: Mrs Smith has a history of heart problems, currently experiencing paleness and chest pain. Decision for Hospital Referral Recommendation: Urgent hospital visit required based on symptoms and medical history. Arranging Ambulance Service Ambulance Dispatch: An ambulance is being arranged to transport Mrs Smith to the hospital immediately. Final Instructions Instructions to Mr Smith: Await ambulance arrival at 12 Mornington Crescent, Snee Green. Contact 999 if conditions worsen before ambulance arrives. Closure of Call Conclusion: Call concludes with instructions reiterated and assurance given regarding ambulance dispatch. https://d3imrogdy81qei.cloudfront.net/video_images/8713/Scenario_2_-_Chest_pain-01.jpg Yes 149 https://www.protriage.co.uk/training/phonetriage/video/mental-health-depression https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4901.mp4 Scenario 3 - Mental health - Depression Urgent Care Call with Mr Smith: Mental Health Assessment Initial Contact and Identification Introduction: Shaun, an Urgent Care practitioner, contacts Mr Smith regarding his recent call. Assessment of Current Situation Current Concerns: Mark Smith discusses his feelings of hopelessness and recent changes in mood. Medical History and Medication Background: Mark reveals a history of depression, currently managed with amitriptyline. Evaluation of Emotional State Discussion: Shaun explores Mark's recent emotional struggles and thoughts of self-harm. Decision for Immediate Care Recommendation: Urgent referral to the Urgent Care Centre at Royal Stoke Hospital for assessment and support. Arranging the Appointment Appointment: Shaun explains the location and process for Mark to attend the appointment at the centre. Final Instructions and Follow-Up Instructions: Mark is advised to wait for a call regarding his appointment and to update if his condition changes. https://d3imrogdy81qei.cloudfront.net/video_images/8747/Scenario_3_-_Mental_health_-_Depression-01.jpg Yes 455 https://www.protriage.co.uk/training/phonetriage/video/lower-back-pain https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4903.mp4 Scenario 5 - Lower back pain Emergency Call with Mr Smith: Severe Back Pain Assessment Introduction and Identification Introduction: Shaun from Urgent Care contacts Mr Smith regarding severe back pain he experienced this afternoon. Assessment of Current Condition Current Symptoms: Mr Smith describes intense lower back pain radiating down his left leg, exacerbated by movement. Medical History and Pain Management Medical Background: Discussion on previous pain relief attempts with ibuprofen and paracetamol. Physical Examination and Recommendations Recommendation: Urgent dispatch of ambulance to assess Mr Smith's condition and administer appropriate pain relief. Arranging Ambulance Service Emergency Response: Details provided to Mr Smith to ensure comfort until ambulance arrival in Stoke-on-Trent (ST16). Final Instructions and Follow-Up Instructions: Mr Smith advised to monitor pain and update emergency services if condition worsens before arrival. Son instructed to assist until help arrives. https://d3imrogdy81qei.cloudfront.net/video_images/8751/Scenario_5_-_Lower_back_pain-01.jpg Yes 301 https://www.protriage.co.uk/training/phonetriage/video/additional-considerations- https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4872.mp4 Additional considerations Telephone Triage Challenges and Solutions Challenges Faced in Telephone Triage Identifying Challenging Groups: Telephone triage can be particularly challenging when dealing with very elderly individuals, young children, persons with learning difficulties, and accidental callers to 111. Handling Different Demographics Every Call Matters: Regardless of who calls, every 111 inquiry is treated seriously, and demographic information is gathered as thoroughly as possible. Children Calling 111: Children sometimes call 111 seeking help independently. In such cases, safeguarding measures may need to be considered, including local safeguarding referrals. Elderly and Vulnerable Callers: Elderly and vulnerable individuals may call 111 for various reasons, sometimes simply for companionship or advice. They are directed to appropriate services to address their needs, including mental health support or assistance with daily living. Overcoming Language Barriers Language Challenges: Language barriers, such as patients speaking broken English, can complicate triage. Services like Language Line are used to facilitate communication effectively, ensuring accurate information gathering and credible documentation. Ensuring Safety and Credibility: Using Language Line enhances safety and credibility by avoiding assumptions and ensuring accurate understanding of patient needs. Dealing with Accidental Calls Handling Wrong Numbers: Accidental calls to 111, such as mistaking it for the police non-emergency line (101), are managed carefully. Details are recorded, and appropriate signposting to other services, if needed, is provided before redirecting the caller. Children and Accidental Calls: Even accidental calls from children are documented and handled with care, ensuring all details are recorded for proper management. https://d3imrogdy81qei.cloudfront.net/video_images/8677/Additional_considerations-01.jpg Yes 178 https://www.protriage.co.uk/training/phonetriage/video/managing-patient-expectations https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4886.mp4 Managing patient expectations Managing Patient Expectations in Triage: Tips and Insights Understanding Patient Expectations Exploring strategies to manage patient expectations effectively during triage: Common Challenges: Patients often arrive with expectations for immediate treatment or specific interventions that may not align with the rapid assessment nature of triage. Experience with Patient Expectations: Addressing instances where patients anticipate outcomes that triage may not directly provide. Strategies for Effective Management Insights into handling patient expectations during the triage process: Setting Clear Expectations: Communicate early on that triage involves a rapid assessment to determine appropriate next steps rather than detailed treatment. Emphasising Safety and Assessment: Ensure patients understand the primary goal is to assess their condition swiftly and direct them to the appropriate level of care. Avoiding False Promises: Refrain from guaranteeing specific tests or treatments (e.g., x-rays, blood tests) during triage to manage expectations realistically. Documenting and Updating: Accurately record patient assessments and decisions made during triage to maintain clarity and continuity of care. By adhering to these practices, healthcare providers can navigate patient expectations effectively in triage settings. https://d3imrogdy81qei.cloudfront.net/video_images/8729/Managing_patient_expectations-01.jpg Yes 115 https://www.protriage.co.uk/training/phonetriage/video/introduction-to-telephone-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4895.mp4 Introduction to telephone triage Telephone Triage vs Face-to-Face Triage Overview of Differences Shawn asks Mark about the differences between telephone and face-to-face triage: Telephone Triage Skills: Requires advanced practitioner skills including prescribing. Communication Challenges: Relies on verbal cues from the patient. Key Steps in Telephone Triage: Introduce yourself and explain the purpose. Obtain consent and confirm patient details. Gather comprehensive information about the patient's condition. Focus on the main complaint to assess urgency. Discuss treatment options and safety netting. Document thoroughly and ensure patient understanding. Compensating for Non-Verbal Communication Mark discusses compensating for lack of non-verbal cues in telephone triage: Utilizing Support: Engage others in the patient's environment for observations. Encouraging Patient Actions: Direct patients to perform self-assessments or use technology for visuals. Technological Support: Use video conferencing or secure photo sharing for better assessment. Physical Observations: Guide patients to provide auditory or visual clues if possible. Imagination and Differential Diagnoses Mark and Shawn discuss the challenges of imagination and differential diagnoses in telephone triage: Imagination and Assessment: Requires envisioning patient environments and conditions. Comprehensive Assessment: Consider multiple possibilities and ensure thorough assessment. Ensuring Patient Safety: If unsure, arrange for face-to-face consultation for a complete assessment. Telephone triage demands skill and adaptability to effectively assess patients remotely, ensuring safety and appropriate care planning. https://d3imrogdy81qei.cloudfront.net/video_images/8753/Introduction_to_telephone_triage-01.jpg Yes 318 https://www.protriage.co.uk/training/phonetriage/video/triage-categories https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4904.mp4 Triage categories Triage Categories in Emergency Care Explained Understanding Triage Categories When patients arrive for triage, they are categorised based on the severity of their condition: Immediate Response (Red Category): Patients needing urgent attention within zero minutes, typically directed to the resuscitation area. Examples include compromised airways or severe trauma. Very Urgent (Orange Category): Patients requiring attention within 10 minutes. This includes cases such as active bleeding or high pain scores necessitating IV analgesia. Urgent (Yellow Category): Patients needing assessment within 60 minutes, often treated in majors or ambulatory units. Examples include conditions like cellulitis requiring IV antibiotics. Standard (Green Category): Patients with less acute conditions, to be seen within 120 minutes. Includes minor injuries or referrals from GPs not suitable for walk-in centres. Non-urgent (Blue Category): Patients requiring assessment within 240 minutes. These cases may be referred to community services, their GP, or a minor injuries unit. Implementation Across Hospitals Despite variations in physical locations, the triage categorisation process remains consistent across hospitals: The categorisation does not alter the response time or outcome, ensuring uniformity in emergency care. Each hospital designates specific areas for different triage categories, such as resuscitation for red patients. Understanding these categories helps streamline patient care and ensures appropriate prioritisation in emergency departments. https://d3imrogdy81qei.cloudfront.net/video_images/8737/Triage_categories-01.jpg Yes 212 https://www.protriage.co.uk/training/phonetriage/video/documentation-and-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4879.mp4 Documentation and triage Importance of Documentation in Triage Process: Procedures and Security Overview of Documentation in Triage Explaining the significance and types of documentation used in the triage process: Digital Documentation: At our hospital, all triage records, including vital signs, are digitally recorded and stored in the patient's electronic health record for their lifetime. Variations Across Hospitals: Practices vary; some hospitals use fully digital systems integrated with IT, while others rely on handwritten records for the patient care journey. Special Cases: For mental health patients, specific pro forma documentation is used to record details like their condition and appearance, ensuring continuity of care and safety. Security and Confidentiality Addressing the importance of securing confidential patient information: Confidentiality Measures: All documentation is confidential and should be securely stored to prevent unauthorized access. Practical Security Practices: It's essential to lock screens and secure computers when not in use to safeguard patient data from breaches. Adhering to these documentation practices ensures accuracy, security, and confidentiality in patient care at all times. https://d3imrogdy81qei.cloudfront.net/video_images/8721/Documentation_and_triage-01.jpg Yes 137 https://www.protriage.co.uk/training/phonetriage/video/course-introduction-telephone-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4789.mp4 Course Introduction https://d3imrogdy81qei.cloudfront.net/video_images/8525/Course_Introduction_-_Telephone_Triage-01.jpg Yes 133 https://www.protriage.co.uk/training/phonetriage/video/active-listening https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4870.mp4 Active listening Effective Telephone Triage Techniques Handling Information in Telephone Triage Addressing the challenges of gathering information over the phone in triage: Listening Skills: Given the absence of visual cues, active listening becomes crucial in telephone triage. Involving Third Parties: Sometimes involving a third party with patient consent can provide valuable insights, especially if the patient is unable to communicate effectively. Language Barriers: Overcoming language barriers by seeking assistance from interpreters ensures clear communication. It's essential to allow the caller to express their concerns fully without interruption to gather accurate information for informed decision-making. Techniques for Active Listening Strategies to ensure effective communication during telephone triage: Reassurance: Provide reassurance and empathy to help the caller feel heard and understood. Summarization: Summarize the information received to clarify and confirm understanding. Confirmation of Understanding: Ensure the caller understands the plan and is comfortable with it before concluding the call. These techniques enhance the quality of communication in telephone triage, facilitating accurate assessment and appropriate patient management. https://d3imrogdy81qei.cloudfront.net/video_images/8725/Active_listening-01.jpg Yes 155 https://www.protriage.co.uk/training/phonetriage/video/what-is-triage https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4897.mp4 What is Triage Understanding Triage in Emergency Settings Definition and Levels of Triage Mark and Shawn discuss the concept and levels of triage: Definition of Triage: Triage is derived from the French word meaning 'to sort'. It involves assessing and sorting patients based on the severity of their condition. Levels of Triage: Includes initial scene triage and major incident triage, adapting to different scenarios and resource needs. Importance of Dynamic Assessment: Quickly determines patient priority and resource requirements. Nurse's Perspective on Triage Mark explains the importance of triage from a nursing perspective: Initial Patient Assessment: Crucial for determining severity and necessary treatment. Consideration of Treatment Needs: Assessing not only severity but also treatment urgency. Pathway Decision-Making: Directing patients to appropriate care pathways to avoid A&E congestion. Effective Triage Process Mark and Shawn elaborate on the efficiency and accuracy of the triage process: Manchester Triage System: Utilises colour-coded urgency levels (Red, Orange, Yellow, Green, Blue) based on initial patient assessment. Speeding Up Patient Care: Ensures timely treatment and reduces waiting times by directing patients to the right care pathway. Importance of Accurate Assessment: Critical for assigning correct priority and ensuring appropriate treatment location. A to E Assessment Mark discusses the A to E assessment process during triage: A to E Assessment: Airway, Breathing, Circulation, Neurological Disability, and Exposure assessment. Quick Evaluation: Rapid assessment to gauge patient severity and immediate needs. Time Frame: Ideally completed within 10 minutes to expedite patient care. Patient Interaction and Satisfaction Mark addresses patient interaction and satisfaction during the triage process: Communication and Comfort: Balancing quick assessment with patient reassurance and understanding. Managing Expectations: Informing patients of the triage process and subsequent care pathway. Closure and Pathway Guidance: Concluding the triage process with clarity on next steps for the patient. Understanding and effectively implementing triage ensures patients receive timely and appropriate care, improving overall emergency department efficiency. https://d3imrogdy81qei.cloudfront.net/video_images/8715/What_is_Triage-01.jpg Yes 435