Physical symptoms that should interrupt routine workflow

Some symptoms require stopping routine booking or administrative handling and triggering clinical review. They may be spoken calmly, written briefly in an online form, or mentioned at the end of another request, but they still need prompt escalation.

Patients often use non-clinical language. A receptionist might hear "tight chest", "can't get my breath", "passed out", "face dropped", "blue lips", "worst pain", "not passing urine" or "getting worse quickly". Record the patient's exact words rather than replacing them with a vague note.

Listen or look for

• Chest pain with concerning features: sweating, sickness, light-headedness, breathlessness or pain spreading to the arm, jaw, neck, back or stomach.
• Breathing difficulty: unable to speak full sentences, blue lips, choking, gasping, noisy breathing or sudden worsening.
• Collapse or reduced consciousness: unconscious, difficult to wake, still drowsy or not fully recovered.
• Stroke symptoms: face drooping, arm weakness, speech problems or sudden confusion.
• Severe allergic reaction: swelling of the lips, tongue or throat, breathing difficulty, collapse or widespread rash with feeling very unwell.

Keep urgent words visible

"Cannot breathe properly and lips look blue" is clearer and safer than "breathing query". "Face dropped and speech slurred" is clearer than "possible stroke?" The next clinician needs the exact wording that raised concern.

Do not let embarrassment, patient politeness, a crowded waiting room or a busy phone line cause urgent symptoms to be treated as routine. If the contact is at reception, local arrangements should let staff summon clinical help immediately.

Reception desk contacts

Urgent symptoms should remain visible in the record and should not be diluted into routine administrative language.