Red flags of disease

Chapter 1 Red flags of disease


Red flags are those symptoms and signs which, if elicited by therapist, either of conventional or complementary medicine, merit referral to a conventional doctor. Referral is indicated because the presence of red flags indicates the possibility of a condition which either may not respond fully to non-medical treatment or may benefit further from conventional diagnosis, advice or treatment.


In summary, referral may be considered for the following four broad reasons:



1. To enable the patient to have access to medical treatment which will benefit their condition.


2. For investigations to exclude the possibility of serious disease.


3. For investigations to confirm a diagnosis and help guide treatment.


4. For access to advice on the management of a complex condition.


It is important to clarify at this stage that the red flags indicate those potentially serious conditions in which the patient would be in need of further tests, advice or treatment. Not all of the red flag conditions listed in this text indicate that the patient will need medical treatment. In some cases referral is advised so that the patient can have tests to exclude an unlikely but important treatable condition (e.g. a mole that might have features of skin cancer), or to obtain a medical diagnosis to guide in the future management of the condition (e.g. ascertaining the severity and cause of suspected anaemia). In other situations it may be important to refer so that the patient can have access to detailed medical advice (e.g. on the complexity of assessing coronary risk and how this impacts on subsequent choice of medical treatment).



Use of complementary medicine and red flags


There are very few examples of when complementary medicine would not be beneficial to someone who is also receiving conventional investigation or treatment for a condition. Therefore, referral in response of a patient with red flag symptoms or signs does not mean that complementary medical treatment need be discontinued, as long as the therapist is sure that the patient has given informed consent to this treatment.



The red flags as guides to referral


Red flags are guides to referral and not absolute indicators. Often the red flags described in this text specify a fixed, measurable point at which referral should be considered, for example high fever (especially if over 40°C) not responding to treatment within 2 hours in a child. Of course, in reality, disease falls somewhere along a spectrum which bridges the state of being of little concern and one of being of serious concern (see Figure 1.1). A disease does not suddenly become serious once a fixed point has passed. Moreover, what might constitute a red flag in one individual may be of less concern in someone of a stronger constitution.


image

Figure 1.1 This illustrates the fact that red flags have to fall at a fixed point along the spectrum of symptoms of mild to serious disease.


Bearing the potential flexibility of interpretation of red flag syndromes in mind, there may well be situations in which the clinical opinion of the therapist is that referral is unnecessary even though a red flag is present. Conversely if a nagging uncertainty persists in a clinical situation, even if the patient does not fit the criteria for any of the red flags, then it is safest to trust clinical instincts and refer. The important thing is that there is an awareness of these indicators of possible serious disease, and that in every case time has been taken to consider their relevance for patients in the clinical situation.



Prioritisation of the red flags


The various red flags merit different responses from the practitioner according to the nature of the underlying condition of which they may be an indication. To aid with decision making in the clinical situation, the red flags listed in this text are assigned to one or more of three categories of urgency.


These categories are:



*Non-urgent: A non-urgent referral means that the patient can be encouraged to make a routine appointment with the medical practitioner (GP) and this ideally will take place within 7 days at the most.


**High priority: A high priority referral means that the patient is assessed by a medical practitioner within the same day.


***Urgent: The urgent category is for those situations when the patient requires immediate medical attention, and this may mean summoning an on-call doctor or calling the paramedics to the scene.

Related posts:

Default ThumbnailC tables: Red flags requiring urgent referral Default ThumbnailRed flags and referrals: Ethical points Communicating with medical practitioners B tables: Red flags ordered by symptom keyword A tables: Red flags ordered by physiological system Study of the Mechanism behind Moxibustion

Stay updated, free articles. Join our Telegram channel
Tags:
Oct 3, 2016 | Posted by in MANUAL THERAPIST | Comments Off on Red flags of disease

Full access? Get Clinical Tree
Get Clinical Tree app for offline access