Phone Triage Framework
A repeatable structure for the cardiology triage call: gather the right information, sort urgency safely, and route the patient.
Learning Objectives
- 1.Run a cardiology triage call with a consistent structure.
- 2.Ask the focused questions that determine urgency.
- 3.Sort calls into emergent, urgent, and routine and route them.
Purpose
Triage isn’t guessing the diagnosis — it’s safely sorting urgency. A consistent framework keeps you from missing a red flag when the phone is ringing off the hook.
Use an approved protocol
Standardized nurse telephone-triage protocols (e.g., Schmitt-Thompson) and AAACN telehealth-nursing standards are the professional basis for these calls: work from an approved protocol, triage UP when uncertain, give return precautions, and document. For a true emergency the patient goes to 911/ED; for everything else, notify the provider per your workflow rather than pulling them out of a room.
What to ask
- •What is the main symptom, and when did it start?
- •Is it happening right now? Getting better or worse?
- •Any chest pain, shortness of breath, fainting, or palpitations?
- •Associated symptoms: sweating, nausea, arm/jaw pain, leg swelling, weight gain?
- •Relevant history: known heart disease, recent procedure, new or missed medications?
What to measure (if available)
- •Home blood pressure and heart rate.
- •Home weight trend (especially for heart failure patients).
- •Pulse oximetry if they have a device.
Sort the urgency
- 1.Screen for red flags first — if present, escalate/route emergently.
- 2.If stable but concerning, route as urgent (provider callback today).
- 3.If mild and non–red-flag, handle per protocol or schedule routinely.
- 4.When uncertain, treat as the higher urgency.
Default up, not down
If you can’t clearly place a call as routine, treat it as urgent. Over-triaging is safe; under-triaging is not.
What to send the provider
- •Patient identity and the one-line reason for the call.
- •Key symptoms, timing, and any red flags.
- •Relevant vitals/weights and pertinent history.
- •Your assessment of urgency and what you recommend.
Spanish phrase
When did the symptom start, and is it happening right now?
¿Cuándo comenzó el síntoma, y está ocurriendo ahora mismo?
KWAN-doh koh-men-SOH el SEEN-toh-mah, ee es-TAH oh-koo-RYEN-doh ah-OH-rah MEES-moh
Mini case
A heart failure patient calls: up 4 lbs in 3 days, more short of breath lying flat, no chest pain, stable vitals at home.
How do you triage this?
Show answer
No emergent red flags, but rising weight + orthopnea signals early congestion — route as urgent for a same-day provider callback, and send the weight trend, symptoms, and vitals. This shouldn’t wait for a routine appointment.
Checklist
- I screen for red flags before anything else.
- I capture symptom, timing, and whether it’s happening now.
- I sort into emergent / urgent / routine and default up when unsure.
- I send the provider a concise, prioritized summary.