Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Effective triage of patients with minor injuries in a primary care setting involves:
- Initial clinical assessment: Take a detailed history including mechanism of injury, symptoms (e.g., pain, loss of function), and any red flags such as altered consciousness, neurological deficits, or signs of serious injury. Use structured tools like the Glasgow Coma Scale for head injuries to assess severity NICE NG232,NICE CKS.
- Identify red flags and risk factors: Recognise signs that require urgent referral or emergency transfer, such as suspected fractures, open wounds, neurological symptoms, or risk factors for complications (e.g., anticoagulant use, severe pain, or inability to mobilise) NICE NG232,NICE CKS,NICE CKS.
- Use clinical judgement supported by guidelines: For example, in head injuries, refer immediately if there are signs of intracranial complications or cervical spine injury NICE NG232,NICE CKS. For musculoskeletal injuries like shoulder pain, consider urgent referral if neurological lesions or severe trauma are suspected NICE CKS.
- Provide safety-netting advice and self-care information: For minor injuries without red flags, advise patients on symptom monitoring, activity modification, and when to seek further care. Ensure a responsible adult can observe vulnerable patients after injury NICE NG232,NICE CKS.
- Facilitate appropriate onward referral: Arrange timely referral to secondary care or specialist services when indicated, ensuring communication with receiving services and safe transport arrangements NICE NG232,NICE CKS.
Summary: Effective triage in primary care requires thorough assessment to exclude serious injury, recognition of red flags for urgent referral, use of validated assessment tools, clear communication, and provision of safety-netting advice for minor injuries NICE NG232,NICE CKS,NICE CKS.