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Case study feedback

Now you have listened and discussed the consultation, read through the following feedback and compare your discussion points.

Is the advice appropriate?

At this stage, the advice given is extremely limited. As the diagnosis is uncertain, that uncertainty should be communicated to the patient. The patient can then be empowered to reconsult if necessary. If there is a recognised risk of deterioration or complications developing, then the safety-net advice should include the specific clinical features (including red flags) that the patient should look out for. Safety-net advice should give specific guidance on how and where to seek further help if needed. Where information about the likely time course of illness is known, safety-net advice should include this information. However, it should be made clear that if a patient has concerns they should not delay seeking further medical advice.

Is the patient well equipped to self-signpost in case of worsening symptoms?

As previously mentioned, the patient has been given a weak time frame of a ‘couple of days’ if the pain doesn’t subside to come back to the clinic. The things to consider are what would the patient do if she develops a fever, experiences extreme muscle weakness or feels that she starts to have more serious mobility issues.

The patient may develop septic arthritis and so it is important that she is aware of the signs and symptoms, as well as how and where to seek medical attention if this becomes the case.

What other advice would you give the patient?

Booking and confirming follow-up appointments before patients leave the consultation.

Patient information leaflets to inform patients when to return to their GP for a clinical review.

What should you consider when safety netting patients?

The patient’s capacity to understand the information and actual understanding the information must be clarified.

If there are capacity issues, the information may be discussed with their parent/carer.

One way of ensuring that the patient has understood what you have told them is ask to recall what they you have just told them, this clarifies to the clinician what they have missed.

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This article is from the free online course:

Conducting Remote Consultations and Triage

UCL (University College London)