Red flags
Who to refer and red flags
Most of the people who attend the pharmacy with a sore throat will be unwell and have pain but are not severely ill. A few patients may attend who have symptoms suggesting more severe illness or who are at risk of severe illness.
The most important requirement is to recognise severely ill patients and ensure they get urgent care.
Also, some patients may seek assessment by the pharmacist but do not meet the necessary service criteria. These patients will need referral to their GP practice (or to urgent care, if required).
The NHS Health A-Z lists the following symptoms as red flags for sore throat. Patients (including children) should call 999 or go straight to A&E, if they are:
- Having difficulty breathing or are unable to swallow
- Drooling – may be a sign of not being able to swallow
- Making a high-pitched sound during breathing (called stridor)
- Having severe symptoms that are getting worse quickly.
The other diagnosis to consider is sepsis – see Table 3.
Patients who appear dehydrated may also need urgent referral. If quinsy or another throat/neck abscess is suspected, these should be referred to A&E urgently.
