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Table 3 Criteria for referral to primary care team (PC) or geriatric evaluation and management team (GM) 1

From: The MRC trial of assessment and management of older people in the community: objectives, design and interventions [ISRCTN23494848]

Clinical domain

Referral Criteria

Bradycardia

Heart rate <50

Tachycardia

Heart rate > = 110

Abnormal ECG

ECG carried out for irregular pulse

Hypertension

Aged less than 80 years average repeat sitting systolic

 

> = 180 mmHg or sitting diastolic

 

> = 100 mmHg. To refer for either,

 

standing systolic must be > = 140 mmHg

Untreated Angina

Positive on Rose chest pain questionnaire

Severe leg oedema

Swelling of legs up to knees on getting up in the morning

Severe shortness of breath

Short of breath on talking

Weight loss

Recent unexplained weight loss of more than half a stone

Depression

GDS score >7 and no treatment or more than 6 months on present treatment

History of recent falls

> 4 falls in previous 6 months

Infected MSU

MSU tested when patient reports urinary incontinence or has proteinuria or haematuria on dipstix

Other urinary problems (men)

Difficulty in micturition Nocturia more than twice nightly

Faecal incontinence

Soiling 3 or more times a week

Faecal occult blood

Blood in motions and stool specimen is positive for blood

Change in bowel habits

Constipation Diarrhoea

Haematemesis

Recent history of vomiting blood

Haemoptysis

Recent history of coughing up blood

Dysphagia

Difficulties swallowing

Glycosuria

Positive for glucose on dipstix

Abnormal biochemistry

Outside normal ranges for haemoglobin, white cell count, platelets, TSH, glucose, sodium, potassium, urea, creatinine, albumin, calcium, bilirubin, alkaline phosphatase, aspartase-transaminase

Potential drug interactions

Modified version of the Stockley checklist

Any other serious condition warranting further investigation

Nurse judgement

  1. 1 Excludes details on criteria for emergency referrals