Telephone triage for flu-like illness

Name of caller
Name of patient, (if different)

Look at patient medical notes to supplement the information provided by patient.

Questions	Assessment Are an of the following present?
Age of the patient	>65 <65 with co-morbidity child <12 (Note —zanamivir not recommended in this age group). May or may not require referral to a doctor depending on overall condition
Pregnancy Are you pregnant or breast feeding?	Pregnant or unsure Breast feeding
Duration When did symptoms start?	<36 Hours >36 hours but <1 week > 1 week
Previous history / co-morbid conditions Are you normally fit and well? Do you have any existing medical conditions?	Any of the following conditions? Asthma requiring regular medication COPD Heart disease excluding uncomplicated hypertension Immunosuppressed (treatment, illness such as asplenia or splenic dysfunction) Diabetes mellitus
Prescribed medication What medicines are you taking? Provides an indication of history if not clearly given by patient. If unsure, check list of common drugs prescribed for these conditions.	Respiratory drugs Cardiovascular drugs Immunosuppressants (including anti-cancer drugs), oral corticosteroids Diabetic drugs
What are the symptoms?
Fever Feeling hot? Sweating, shivering?	Marked fever
Cough Have you got a cough? Are you coughing anything up? What colour is the sputum?	Unproductive cough Productive cough, coloured sputum, blood stained
Breathlessness Have you any difficulty breathing apart from nasal congestion?	Breathing difficulties, chest pain
Loss of consciousness Have you fainted or lost consciousness	Loss of consciousness, delirium
Rash Do you have a rash anywhere on your body?	Rash
Sore throat Have you any difficulty swallowing?	Difficulty swallowing
General aches and pains Muscle and joint aches? Headache?	Joint aches and pains Headache
Lethargy Are you feeling tired and lethargic?	Lethargy, tiredness
Fluid intake Are you eating or drinking anything?	Not drinking fluids Loss of appetite
Nausea/vomiting Are you feeling sick? Have you been sick?	Nausea Vomiting
Medicines already tried Have you taken any pain killers or cough or cold remedies e.g. paracetamol, aspirin, ibuprofen?	Taken Analgesics Cold remedies NB Caution in advising paracetamol if cold remedies have already been taken. Reinforce maximum dose.

Action

BLUE

RED

BLACK

Ask GP to prescribe zanamivir if:

Flu is circulating and
Patients are >65 or <65 with co- morbidity and
Has presented within 36 hours of onset with most of blue symptoms

Advise rest and fluids

Patients who fulfil any of the red conditions should be referred to a doctor for further advice.

Patients in the black category do not fit the criteria for zanamivir and do not require referral to the doctor.

Advise home care if:

There are blue symptoms which suggest cold or flu

Advise

Rest
Adequate fluid intake
Analgesics
Cough/cold remedies