GENERAL PRACTICE or AH SERVICE​​
 DISCUSS WITH GP OR NURSE NOW
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  • Abdominal Pain - if the abdominal pain is so severe that it changes the patient's posture i.e. they must walk bent over or lie with their knees drawn to their chest; this is highly suggestive of referral directly to an Emergency Department.
  • Adverse reaction to medication
  • Bites and Stings  - if there difficulty breathing or the bite is from a any large black spider or any snake or known venomous creature, the patient should be directed to Ambulance OOO
  • ​Burns/Scalds - if any part of the burn is black or charred or the burnt area is bigger than the patients hand; this is highly suggestive of referral directly to an Emergency Department.
  • Convulsions/Fitting (not current)
  • Death of a patient 
  • Eye or vision problems -  any obvious injury to the eye or an embedded object or sudden loss of sight or the quality of sight; this is highly suggestive of referral directly to an Emergency Department. 
  • Fevers (hot to touch) in infants especially a newborn to 3 months
  • Lacerations - if the bleeding cannot be controlled or is from any body orifice or is longer than 20mm or if there is white or yellow substances visible in the wound; this is highly suggestive of referral directly to an Emergency Department. 
  • Limb Injury - if the limb is deformed or not in normal alignment or is pale compared to the other limb or there is a loss of function or feeling in the limb or the patient cannot bear weight/walk; this is highly suggestive of referral directly to an Emergency Department.
  • Limb Pain (without injury)
  • Mental Health Problems ​or Extreme Anxiety - including suicide ideation 
  • Parent/carer concern
  • Persistent vomiting
  • Severe pain (from any cause not mentioned in Ambulance or ED lists)
  • Suspected Meningitis - concern by parent or carer
  • Urgent Pathology Result
  • Vaginal bleeding in pregnancy​

The above list has been formulated to assist practice staff in establishing the broad risk patients based on their chief complaint and/or situation.  It is not designed to be diagnostic but to assist practice staff in the timely referral to practice clinical staff and other places of care for emergency matters.  This system is based on a variety of clinical guidelines and evidence from general practice feedback.  The authors have prepared this resource for practices based on the information available at the time.  As the authors cannot control how the resource is used in practices, they accept no liability for using or not using this information.