Danger Elimination Flashcards
(38 cards)
Mouth Ulcers
WWHAM:
- Longer than 3 weeks
- ADRs
- Failed treatment
Other:
- Bigger than 1cm
- More than 5-10 ulcers
- Painless ulcers
- Unexplained weight loss
Timescale 1 weeks
Oral Thrush
WWHAM:
- Failed medication
- Diabetes
Other:
- Painless lesions
- Recurrent infection
Timescale 1 week
Dyspepsia
WWHAM:
- Persistent (>5 days)
- ADRs
- Failed treatment
Other:
- > 45 and first time for symptoms
- Blood in vomit or stools
- Difficulty swallowing
- Regurgitation
- Uninentional weight loss
- Pain worsens on effort
- Pain is severe
- Pain radiates to arms
- Children
Timescale 1 week
Nausea and Vomiting
WWHAM:
- duration of more than 48 hours
- refer anyone under 2
Other:
- Blood in vomit or stooks
Timescale 48 hours for adults
Motion Sickness
WWHAM:
- Failed treatment
- Glaucoma
Constipation
WWHAM:
- Change in bowel habit of 2 weeks or longer
- Failed OTC medication
- ADRs
Other:
- Blood in stools
- Abdominal pain, vomiting
Timescale 1 week with OTC treatment, 2 weeks with dietary advice only
Diarrhoea
WWHAM:
- > 1 day in children <1 year
- > 2 days in children <3 years and elderly
- > 3 days in older children and adults
- History of change in bowel habit
- Suspected ADR
Other:
- Recent travel abroad
- Presence of blood/mucus in stools
- Pregnancy
Timescale 1 day in children, 2 days for anyone else
IBS
WWHAM:
- No history of IBS and no precipitating factors
- Failed treatment
Other:
- Unexplained weight loss
- Under 16
- Blood in stools
- Nausea/vomiting
Timescale 1 week
Threadworms
WWHAM:
- Medication failure
Other:
- Signs of bacterial infection
- Recent travel abroad
Timescale 2-3 weeks
Haemorrhoids
WWHAM:
- Longer than 3 weeks
- ADRs
Other:
- Blood in stools
- Persistent change in bowel habit
Cold and Flu
- Persistent high temperature
- Difficulty breathing/wheezing
Timescale 10-14 days
Sore throat
WWHAM:
- Long duration (2-3 weeks)
- ADRs (agranulocytosis)
Other:
- Unable to swallow
- White exudate on tonsils
- Recurrent infection
Timescale 1 week
Cough
WWHAM:
- Long duration (2-3 weeks)
Other:
- Difficulty breathing/shortness of breath
- Coloured sputum
- Persistent nocturnal cough in children
- Croup/whooping cough
Timescale 2 weeks
Seasonal Rhinitis (Hayfever)
WWHAM:
- Failed medication
Other:
- Wheezing/shortness of breath
- Tight chest
Timescale 5 days
Perennial rhinitis
WWHAM:
- Failed medication
Other:
- Wheexing/shortness of breath
- Tightness of chest
Timescale 5 days
Tension Headache
WWHAM:
- Severe and >4 hours duration
- ADRs
- Children <12 years
Other:
- Associated head injury/trauma
- Location and type of pain (severe occipital and raised ICP)
- Nausea and vomiting
- Neck Stiffness
- Frequently recurring
Timescale 1 day
Migraine
WWHAM:
- Severe and >4 hours duration
- ADRs
- Children <12 years
Other:
- Associated head injury/trauma
- Location and type of pain (severe occipital and raised ICP)
- Neck Stiffness
- Frequently recurring
Timescale 1 day
Sprains and Strains
WWHAM:
- ADRs causing falls/bruising
- Medication failure
Other:
- Suspected fracture
Timescale 5 days
Backache
WWHAM:
- Medication failure
Other:
- Severe pain
- Pins and needles radiating to leg
- Middle/upper back pain
Timescale 5 days
Repetitive strain injuries
WWHAM:
- Medication failure
Other:
- Suspected fracture
Timescale 5 days
Vaginal thrush
WWHAM:
- OTC failure
- Diabetics
- Under 16
- Over 60
Other:
- First occurrence
- More than 2 in 6 months
- Pregnancy/suspected pregnancy
- Blood stained or strong smelling discharge
Timescale 7 days
Cystitis
WWHAM:
- Failed medication
- Diabetics
Other:
- All men and children
- Fever, nausea, vomiting
- Loin pain
- Haematuria
- Pregnancy
- Recurrent cystitis
Dysmenorrhoea
WWHAM:
- Abnormal bleeding or discharge
- Medication failure
Other:
- Severe intermenstrual pain
- Presence of fever
Timescale 2 cycles
Insomnia
WWHAM:
- Medication failure
Other:
- Suspected depression
- Insomnia lasting more than 3 weeks
- Children under 16
Timescale 1 week
