urgency levels

PRIORITY ONE

​AMBULANCE OOO​​

  • ​Assault including a stabbing or shooting or an assault using another weapon
  • Bite or sting from any large spider, snake or suspected venomous creature
  • Breathing difficulties (severe) - can only speak in short sentences
  • Chest pain or chest tightness (Chest pain lasting longer than 20 minutes or that is associated with sweating, shortness of breath or radiation to another part of the body is to be considered a ‘heart attack’ until proven otherwise, regardless of the age of the patient).
  • Fainting
  • Fall from greater than the patient's own height (in person over 65 years all falls from a standing height)
  • Fitting infant/ toddler 
  • Heart palpitations (severe)
  • Injuries caused by a motor vehicle accident >60km/h or pedestrian/cyclist >30km/h
  • Overdose, poisoning or attempted suicide
  • Respiratory and/or Cardiac Arrest
  • Seizure without a previous diagnosis of epilepsy
  • Seizures that are frequent and/or repeating in an epileptic patient
  • Severe burns, particularly in young children (greater than the patient's hand or if deeper than the top layer of skin in any person)
  • Severe pain for any reason
  • Sudden collapse or unexplained fall
  • Sudden onset of weakness, numbness or paralysis of the face, arm or leg
  • Suspected severe allergic reaction/ anaphylaxis
  • Suspected spinal injury
  • Unconsciousness
  • Uncontrollable bleeding
  • Unexplained fitting in adults
  • Vomiting blood
​PRIORITY TWO

​EMERGENCY DEPARTMENT

​Some of these conditions may require Ambulance treatment and transport to an Emergency Department
  • Any sudden, severe pain, especially in the abdomen or the back
  • ​Anything impaled in any part of the body
  • Broken bones or dislocated joints - deformed or not in normal alignment
  • Burns especially to face or genitals  
  • Cuts with exposed tissue or where the feeling or temperature of the part is not normal
  • Deep cuts that require sutures – especially on the face
  • Embedded object in the eye
  • Flu-like symptoms that are severe or coughing up blood
  • Head injuries - where there has been a loss of consciousness or persistent dizziness and/or vomiting
  • Inability to urinate 
  • Pain in pregnancy
  • Persistent high fever despite medication 
  • Pregnancy - reduced movement
  • Pregnancy - ruptured membranes 
  • Severe testicular pain
  • Sudden change in mental state or difficulty speaking
  • Sudden changes in vision
  • Unusual headaches or migraines (for the patient)​
  • Young children who have stopped drinking or passing urine

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​PRIORITY THREE

​DISCUSS WITH GP OR NURSE NOW

  • 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 is difficulty breathing or the bite is from 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 are 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​


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PRIORITY FOUR

DISCUSS WITH GP OR NURSE WITHIN 30 MINUTES

  • Prescription has run out - refer to GP or nurse to determine urgency and solution
  • Swollen Limb
  • Under-dose (Including missed dose)​​
PRIORITY FIVE

​COME TO THE PRACTICE NOW TO BE ASSESSED BY NURSE OR GP 

  • Adult Vomiting and/or Diarrhoea for > 72 hrs
  • Sudden Rash - without other symptoms
  • Unwell Child (<3yo) or Elderly Patient (>65yo) - with persistent symptoms (>48hrs) such as fever, vomiting, diarrhoea, cough)
PRIORITY SIX

MAKE AN APPOINTMENT TODAY OR WITHIN 6 HOURS (IF UNABLE TO MEET TIME FRAME DISCUSS WITH NURSE OR GP)

  • Back Pain - associated with an accident (e.g. fall, MVA, lifting) provided the patient has no loss of feeling or function in a limb and no loss of bladder or bowel control. 
  • ​Ear Pain - despite pain relief >48 hrs
  • Eye Problems Sickness Certificate
  • Fever in Adults - who are otherwise well 
  • Flu-like symptoms - with current symptoms of risk
  • Patient has a deadline for travel or specialist appointment needing referral
  • Patient has no other opportunity to see GP
  • Post-operative Problems - if there is active bleeding DISCUSS WITH GP OR NURSE NOW
  • Urinary Problems - but able to urinate 
  • Worker's Compensation (injury first report)
  • Wound Infection

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FOR MORE INFORMATION ON WHAT TO DO...CLICK ON THE GUIDELINE BUTTON BELOW THAT BEST SUITS YOUR ROLE IN THE PRACTICE
Note: These recommended outcomes may vary depending on the location and capacity of your practice.