It can be difficult to triage infant health risks over the phone due to the fact that these patients are unable to verbalize why they don’t feel well, or where they’re experiencing discomfort. Triage nurses must know how to obtain the necessary health information from the parents or guardians who call on their children’s behalf. They must also keep in mind that callers may be distressed, which is often the case for new parents. Consider the following example of a call involving an infant, as well as the steps the responding nurse takes to guide the caller to the appropriate level of care.
Case Study: Baby Georgia
Baby Georgia’s mother calls a triage line to ask whether her daughter’s symptoms indicate that she should be taken to the ER. Georgia has developed mild nasal drainage, congestion, and a dry-sounding cough that’s gone on for about two weeks. Now she’s also running a 101-degree fever. Instead of her usual playfulness, Georgia seems tired and has been crying, napping, and clinging to her mother more than usual.
None of these are obvious red flags. However, a triage nurse should always be thinking about the worst-case scenario, so these symptoms are important to keep in mind in order for the nurse to accurately determine the appropriate level of care.
Newborn Health Risks
While Georgia is not technically a newborn at six months old, the triage nurse should know the milestones for her age in addition to any subtle symptoms of infant health risks. This is because:
- Even serious illnesses in infants present mild symptoms, including bacterial sepsis, congestive heart failure, herpes simplex, and meningitis, among others.
- Newborns are considered high risk, especially through age seven.
Tools and Questions Your Nurses Need
Telehealth nurses perform the most effective triage when they have the best tools and know the appropriate questions to ask. That’s why ours use the most up-to-date Schmitt-Thompson protocols, coupled with intuitive triage software. While initial questions may be broad — like “What is normal for your infant?” or “What is your baby doing right now?” — they get progressively more specific:
- Is your baby acting sick in any way? (Note: new parents may think that only a cough, cold, or runny nose are symptoms of an illness.)
- Does your baby have any symptoms?
- What’s your baby’s temperature?
- Has your baby’s color changed?
- How is your baby’s breathing?
It’s important that triage nurses prompt callers to go into as much detail as possible. This often means encouraging them to count their child’s respirations, look for retractions or nasal flaring, compare skin color during and after a cough, and explain how long their child has been exhibiting symptoms.
Using the example above, based on this caller’s feedback about her daughter’s crying and fever, the triage nurse determines that baby Georgia should be seen by her pediatrician tomorrow. The nurse also offers the mother homecare advice to ease Georgia’s symptoms until then, and encourages the mother to call the triage line back if those symptoms worsen. Georgia’s information is then saved to a file within triage software, and shared securely with her pediatrician’s office for continuity of care.
The next day, after reviewing Georgia’s file, her pediatrician diagnoses her with an ear infection and prescribes the appropriate antibiotics.
What Triage Nurses Must Do on Every Call
To review, it’s important that triage nurses remember to do the following on every call involving infant health risks:
Identify Themselves. Nurses should mention their name to a caller, and ask the caller for theirs.
Obtain Health History. Triage nurses should ask for an infant patient’s health history, and never diagnose or deviate from their protocols.
Discuss Homecare and Symptoms. When offering homecare advice, nurses should include a list of symptoms to watch out for, in case an infant’s health worsens before they can see a medical professional.
Provide Callback Instructions. Triage nurses should encourage a parent or guardian to call a triage line back if symptoms worsen, so that they can advise on whether the patient should seek immediate medical care.
If you’d like additional triage tips, check out our free training materials available through our Learning Center. Or, if you’re looking for triage support to handle issues like infant health risks, let’s schedule some time to talk about outsourcing it through our Nurse Triage On Call.
TriageLogic is a URAC-accredited, physician-led provider of top-quality nurse telehealth technology, remote patient monitoring, and medical call center solutions. Founded in 2007, the TriageLogic Group now serves more than 9,000 physicians and covers over 25 million lives nationwide.