The triage safety check
What the safety check looks at, what its six outcomes mean, and — just as important — what it cannot do.
Before anything else, every encounter goes through a safety check. It reads what you recorded — symptoms, severity, vitals, the patient's age, pregnancy status and known conditions — and looks for warning signs that need a doctor.
Select Run triage on the encounter. The result appears straight away.
It is rules, not a guess
The safety check is a fixed set of written rules. It is not artificial intelligence and it does not learn or improvise. The same facts always give the same answer, and every warning sign it reports comes with the plain-language reason it fired, so you can judge it for yourself.
This is deliberate. A safety check has to be predictable and explainable.
The six outcomes
| Outcome | What it means | Stops the workflow? |
|---|---|---|
| Self-care | No warning signs found. Self-care advice may be appropriate. | No |
| Pharmacy management | No warning signs found. Suitable for management in the pharmacy — this is what a patient with a known long-term condition gets when nothing else applies. | No |
| Routine referral | A routine medical referral is advisable. | No — it is one of your decision options |
| Same-day review | Consider a same-day medical review. This is also what a severe presentation with no specific rule gets. | No — it is one of your decision options |
| Urgent referral | Urgent medical evaluation is needed. | Yes |
| Emergency | Immediate medical assessment or emergency referral is needed. | Yes |
Urgent referral and Emergency are the two that open a mandatory escalation. You cannot continue until you have documented what you did — see Escalation and overrides.
What it looks for
The rules cover well-known danger patterns, for example:
- Chest pain together with a very high blood pressure, or with shortness of breath.
- Fever with a stiff neck.
- Bleeding in a pregnant patient.
- Signs of a severe allergic reaction — swelling of the lips or face, or a rash with difficulty breathing.
- Thoughts of suicide or self-harm.
- Low oxygen saturation (below 94% is urgent, below 90% is an emergency).
- A blood pressure at crisis level (180 systolic or 120 diastolic, or higher).
- A very high fever (40°C or above).
- A child under two with a significant fever.
- A patient over 65 with chest pain, confusion or fainting.
- Known diabetes with confusion or fainting.
- A sudden, severe headache described as the worst ever.
- An abnormal heart rate in a severe presentation.
When several rules fire, the most urgent outcome wins and every warning sign is listed.
What it cannot do
Read this part.
- It only knows what you entered. A symptom you didn't record can't raise a warning. Use your own judgement and ask the questions you would normally ask.
- It is a starter set of rules, not every danger there is. A clear result means "none of these rules fired", not "the patient is safe".
- It doesn't replace clinical judgement. It can't examine anyone.
- The symptom words matter. It matches wording such as chest pain or shortness of breath. The quick-pick list uses those exact words; if you type your own, use plain, common terms.
You can always escalate a patient yourself whatever the check says.
AI clinical reasoning is not a second safety check
If your workspace has AI clinical assistance on, a later step may show an AI-written "safety considerations" note. That note is advisory only — it can never change the result on this page, and it never gates anything. This page's result is the one thing that stops the workflow. See AI clinical reasoning.
Related
Starting a clinical encounter
Record why a patient has come — the type of visit, their symptoms, severity, duration and vitals — before the safety check runs.
Escalation and overrides
When the safety check finds a high-risk sign, nothing else can proceed until you document what you did. How that works, and how an override is recorded.