Exam Pass Notes

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A Simple Safety Memory Aid

• Notice the warning words
• Stay within role
• Use the local route
• Record the facts
• Hand over clearly
• Close the loop

Recognise

• Babies and young children may show serious illness through behaviour, feeding, colour, breathing, responsiveness and wet nappies.
• A baby under 3 months with fever, poor feeding, floppiness, mottled or blue colour, difficulty waking or no wet nappies needs urgent escalation.
• Children with breathing difficulty, a non-blanching rash, seizures, stiff neck, confusion, dehydration or severe pain must be removed from routine workflow.
• Pregnancy warning signs include reduced fetal movements, heavy bleeding, leaking fluid, severe abdominal pain, severe headache, collapse, chest pain or breathlessness.
• Recent pregnancy remains relevant when symptoms include fever, heavy bleeding, severe abdominal pain, breathlessness, chest pain, severe headache or a mental health crisis.

Respond

• Use the local urgent escalation route as soon as concerning wording appears.
• Do not diagnose or clinically triage from reception, care navigation or call-handling roles.
• Do not give clinical reassurance or say it is safe to wait when urgent wording is present.
• Escalate uncertainty rather than attempting to manage unsafe symptoms yourself.
• Follow maternity, early pregnancy, crisis or safeguarding pathways where local protocols direct this.

Record and Handover

• Record exact words, time, contact route, patient location and safe call-back details.
• Record relevant context, such as baby or child age, pregnancy status, recent pregnancy status, and who is calling.
• Record action taken, including who accepted ownership and which urgent route was used.
• Document complications such as refusal, failed call-back, disconnection, online delay or remaining uncertainty.
• Keep urgent wording visible rather than reducing it to vague phrases such as "unwell", "feeding query" or "pregnancy advice".

Practice Systems

• Staff need visible prompts, clear scripts, named urgent clinical contacts and backup routes.
• Online requests and routine queues should be monitored so urgent wording about children or pregnancy is not missed.
• Failed-contact rules should state what to do when calls drop, patients leave, or urgent ownership is delayed.
• Near misses should prompt learning and system improvement rather than only individual reminders.