‘Telephone Triage’: a possible means of managing the after-hours patient load at primary health care facilities in South Africa

Figures & data

Figure 1: Percentage of households with a functional landline and cellular telephone in their home by province, 2013. Note: Statistics SA 2013: Statistical release P0318 (General household survey 2013). Page 51: Table shows percentage access to landline and cell phone as a means of communication across the nine provinces in South Africa; 95% of households have access to one or both forms of communication.

Figure 2: Conventional triage pyramid with telephone triage care as the base.

Table 1: Telephone triage table

Number	Classification	Colour	Action
1	Needs resuscitation	Red	Bring patient to ED immediately
2	Very urgent	Orange	Do A, B and C, then bring the patient to the ED
3	Urgent	Yellow	Do A, B and C, then bring patient to ED next morning
4	Standard	Green	No need for ED care, come to outpatient unit next morning
5	Non-urgent	Blue	No need for hospital care, so come to outpatient unit at own convenience

Table 2: Telephone triage scores and possible action

Telephone triage scores	Yes	No	If yes: Action
Trauma	1	0	Pressure to control bleeding, splinting … …
Confused/unconscious	2	0	Put in recovery position if post-ictal
Feel hot	1	0	Panadol + tepid sponge
Breathing fast	1	0	Expose to fresh air/MDI if known asthmatic/COPD
Immobility (less than72 hours)	1	0	Position not to compromise breathing
Flame burns	1	0	Cover burns with wet towels/Panadol
Hot water burns	1	0	Cover burns with wet towels/Panadol
Chest pain (less than 2 hours, not known PUD patient)	1	0	Panadol/aspirin/isordil  …  depending on baseline medical condition
Vomiting (x 2 in last 60 minutes)	1	0	ORS, gradually
Diarrhoea	1	0	ORS, gradually
Irrational behaviour (first episode)	1	0	Call police
Irrational behaviour (known psychiatric patient)	1	0	Call police
Abdominal pain	1	0	Analgesics
Bleeding	1	0	Depending on the orifice
Total score	15

Note: MDI = Metered dose inhaler; COPD = chronic obstructive pulmonary disease; PUD = Peptic ulcer disease; ORS = Oral rehydration solution.

Table 3: Telephone triage score 15

⊡ Total score: 15

⊡ Red = 6+/15

⊡ Orange = 4 &5/15

⊡ Yellow = 2 &3/15

⊡ Green = 1/15

⊡ Blue = 0/15