It is vitally important to be able to convey seriousness to another clinician
SEVERITY
- ‘Moderately severe’ , ‘Severe’ e.g. Moderately severe UTI
- ‘In extremis’ e.g. APO presenting in extremis
- ‘Critical’ e.g. Critically injured patient, Critical aortic stenosis
- ‘Seriously unwell’ e.g. Elderly patient seriously unwell with pneumonia
- ‘Profound’ e.g. Profound hypoxaemia
- ‘Significant’ e.g. Significant pain from renal colic
- ‘Debilitating’ e.g. Metastatic cancer with debilitating pain, Debilitating sciatica
RAPID DETERIORATION
- ‘Acute’ e.g. Acute loss of vision
- ‘Sudden’ e.g. Sudden deterioration in conscious state
- ‘Progressive’ e.g.Progressively worsening abdominal pain, Progressive leg weakness
- ‘Rapidly spreading’ e.g. Rapidly spreading cellulitis/rash
- ‘Acute on chronic’ e.g. Acute on chronic confusion, Acute on chronic renal failure
- ‘Deteriorating’ e.g. Deteriorating liver function
- ‘Unstable’ – Unstable diabetes, Unstable angina, Lower GI blood loss with haemodynamic instability
INADEQUATE RESPONSE TO TREATMENT
- ‘Unresponsive to treatment’ e.g. Abdominal pain unresponsive to opioids, Infected foot ulcers unresponsive to oral antibiotic treatment, Asthma exacerbation not responding to rescue nebs
SPEAK THEIR LINGO – Examples
| Specialty | Descriptions |
| Orthopaedics | Markedly angulated or displaced fracture Fracture with significant deformity Dirty, compound fracture Fracture/Dislocation Neurovascular compromise |
| Plastics | Complex wound Wound with significant devitalised tissue Tissue loss Leg wound in a vasculopath |
| Urology | Gross haematuria with large clots |
| ENT | Marked airway swelling Compromised airway |
| Neurosurgery | CHI with abnormal CT |
| Vascular | Leaking/Ruptured AAA Acute cold/blue/pulseless leg |