How does telephone triage in vet services work?

The first triage will usually be done over the phone to assess how quickly the animal needs to be seen.

It is of vital importance that receptionists or nurses answering the phone are well trained in triage, and ask clear, concise questions where possible.

The owners’ concern should not be dismissed, and there should always be an offer to be seen.

The call should be logged, and owner details, patient signs and advice given recorded. Approximate estimated time of arrival (ETA) should be made, and the owner should be given directions if they have not attended the practice before.

The owner should be advised how to transport the patient safely, e.g., if trauma, potential fracture sites should be immobilised, and the patient should be moved carefully into the car; any small species that can fit comfortably in a carrier should be put into a carrier so they can be accessed easily.

The owner should be made aware that if the patient is in pain or has behavioural changes, it can become aggressive and may require muzzling, so advise the owner to tie tights/string around the muzzle when moving.

Treatment advice should be given if deemed appropriate, e.g., cooling a potential hyperthermia patient before going in a hot car; however, this should delay the veterinary treatment as little as possible.

A suggested list of patients that should be asked to come in immediately include:

• Respiratory distress
• Collapse
• Seizuring (if >5 minutes long)
• Non-responsive
• Cyanosis
• Toxin ingestion
• Seen or suspected trauma — even if the owner thinks their pet is fine
• Rapid abdominal distension and retching
• Moderate to severe pain• Inability to urinate
• High temperature
• Neonates — even if mild signs
• Exotics — even if mild signs

If the following are not stated when the owner is describing the presenting complaint, the following questions should be asked to determine if the pet needs urgent treatment:

• Current signs?
• Any known or suspected toxin ingestion? (If yes to toxin ingestion the patient will need to be seen immediately)
• The onset of signs – gradual progression or rapid deterioration? (Rapid deterioration indicates a more acute disease process and will require seeing more urgently)
• Current medical conditions?
• Current medication – has it been given? Advise the owner to bring it along with them
• Able to breathe easily? Any noise? Open mouth (if cat)? (Any patient with compromised breathing should be seen immediately)
• Acting normally? Able to respond to name, able to walk normally? (Patients with a change in behaviour should be advised to come in straight away)
• Any recent trauma? (Any patients with recent trauma should be advised to come in immediately)

From this information, the patient can be deemed an emergency requiring urgent medical attention, or non-urgent requiring a routine appointment, and advised to come into the hospital accordingly.

The hospital can use one of the triage systems described previously or devise their own. Staff members should be made aware of any emergencies that are coming in, so equipment can be set up, and a nurse can be in reception ready to triage.