Telephone Triage Questions to Ask Patients
Questions used when assessing a patient by telephone, ordered so that identification and immediate risks come first and history follows. They are a prompt for a conversation, not a substitute for the triage protocol your service requires you to use.
The questions
Open any question for the note
Can I take your name, date of birth, and a number I can call you back on?
Why ask it
Taken first because calls drop, and a caller who becomes too unwell to continue cannot always redial. It also confirms you have the right record before anything clinical is discussed.
Are you calling about yourself or about someone else?
Why ask it
Third-party calls carry a step of interpretation, so ask whether the patient can come to the phone. If they cannot, note the reason, since being unable to speak is itself a clinical finding.
What is the main problem today?
Why ask it
Record the answer in the caller's own words before you start narrowing it down. Callers often lead with the most embarrassing or the most recent problem rather than the most serious one, so leave room to return to this.
Are you having any difficulty breathing right now?
Why ask it
Asked early because it changes the pathway immediately. Listen as well as ask: pauses mid-sentence, speaking in short phrases, or audible effort matter more than the answer given.
Do you have any pain or tightness in your chest?
Why ask it
Ask about the character and where it spreads, not only whether it hurts. Presentation varies, and in older patients and people with diabetes discomfort may be mild or absent while the event is serious.
Is there any bleeding that will not stop, or any injury from a fall?
Why ask it
Both can be omitted because the caller has already decided they are unrelated. Ask specifically about anticoagulants alongside this, since a minor knock matters more for someone taking them.
Have you noticed any sudden weakness, numbness, or trouble speaking?
Why ask it
Sudden onset is the part to pin down, including symptoms that came and went. Callers routinely downplay something that resolved after ten minutes, and the time of onset determines what can be done.
Do you feel confused, unusually drowsy, or faint when you stand up?
Why ask it
Worth asking the caller and, if someone else is present, asking them separately. Relatives notice altered behaviour that the patient cannot report, and new confusion is a red flag at any age.
When did this start, and what has happened since?
Why ask it
Direction of travel guides urgency more than the current snapshot. Something steadily worsening over six hours needs a different response from the same symptom that has been stable for a fortnight.
On a scale of nought to ten, how bad is it now, and what was it at its worst?
Why ask it
The gap between the two numbers is the useful part. Pain that began abruptly at maximum intensity, or that wakes someone from sleep, deserves more attention than the current score alone suggests.
Have you had anything like this before, and what happened then?
Why ask it
Establishes whether this is a familiar pattern or genuinely new. A caller saying this feels different from their usual episodes is a signal worth recording and acting on.
Do you have a temperature, and have you been able to measure it?
Why ask it
Record whether the figure is measured or estimated, and with what. Note that a normal or low temperature does not rule out infection, particularly in older or immunosuppressed patients.
Have you been vomiting or had diarrhoea, and are you keeping fluids down?
Why ask it
Ask how long it has gone on and whether anything is staying down. Inability to keep fluids down changes the plan quickly for small children, older adults, and anyone with diabetes or kidney disease.
Are you passing urine as normal?
Why ask it
A simple proxy for hydration and, in some presentations, for something more urgent. Note the last time they passed urine rather than accepting a general impression.
What medicines are you taking, including anything you have bought yourself?
Why ask it
Over-the-counter and herbal products are usually left out unless named. Ask about painkillers taken today, since paracetamol totals across combination products are a common and avoidable problem.
Have any of your medicines changed in the last few weeks?
Why ask it
New drugs, stopped drugs, and dose changes all cause symptoms that get attributed to illness. Ask about courses that have finished as well as ones just started.
Do you have any allergies or reactions to medicines?
Why ask it
Needed before any advice about treatment is given, and worth confirming against the record rather than assuming it is current. Ask what the reaction actually was, since intolerance and allergy are often conflated.
What conditions are you already being treated for?
Why ask it
Diabetes, immunosuppression, pregnancy or recent childbirth, and heart, lung, and kidney disease all lower the threshold for review. Ask directly about pregnancy where relevant rather than waiting for it to be mentioned.
What is worrying you most about this?
Why ask it
Often the single most informative question on the call. It surfaces the symptom the caller has not mentioned, the family history behind the anxiety, or a change in condition they assumed was irrelevant.
Is there anything else you think I should know?
Why ask it
A plain closing question that gives room for what was held back. Follow it by summarising the plan and the specific reasons to call back, and confirm the caller can repeat them.
Assessing a patient you cannot see
Practical guidance for the conversation itself
Working within your protocol
Use your service's approved system
These questions are a prompt list, not a triage algorithm. Where your service uses a validated protocol or decision support tool, that takes precedence, and departures from it should be recorded with your reasoning.
Speak to the patient where you can
Information relayed by a third party loses detail and gains interpretation. If the patient cannot come to the phone, record why, and treat inability to speak as part of the clinical picture.
Cut the questioning short when the answer is already clear
Once a call meets criteria for emergency care, arranging it comes before completing the history. Stay on the line, confirm the address, and gather the rest afterwards if there is time.
What to listen for
Speech and breathing
How the caller talks carries information the answers do not: sentence length, pauses for breath, slurring, effort. Note it explicitly rather than leaving it as an impression.
Background sounds and other voices
A relative prompting in the background, a child audible in distress, or a very quiet house all add context. If someone else is present, it is often worth asking to speak to them.
The reason behind the call
People rarely ring about something that started three weeks ago because of the symptom alone. Ask what changed today, and what made them decide to call now.
Closing the call safely
Give specific reasons to call back
"If you get worse" is too vague to act on. Name the changes that should prompt another call, such as a new rash that does not fade under pressure, being unable to keep fluids down, or increasing breathlessness, and say who to contact out of hours.
Check the plan has been understood
Ask the caller to tell you back what they are going to do and when. Repeating it back reveals the misunderstandings that a simple yes conceals.
Document what was said, not what you concluded
Record the caller's own words, the questions you asked, the negatives you established, and the advice given. Negative findings are what show the assessment happened at all.
Recurring pitfalls
Anchoring on the opening line
The stated reason for calling shapes everything that follows. Ask an open question after the first cluster of answers so a second problem has room to appear.
Reassurance based on a normal reading
A normal temperature, a low pain score, or a caller who sounds composed can all coexist with serious illness. Weigh the whole picture, and record the reasoning behind a decision not to escalate.
Repeat callers
A second or third call about the same problem is a reason for a lower threshold, not a higher one. Check what has already been tried and what has changed since.
Language and hearing barriers
Do not rely on a family member to interpret clinical detail where an interpreting service is available. Slow down, use short sentences, and confirm understanding at each step.