Pediatric Telephone Triage for Dehydration Risk
Key Points
- Children under age 2 can decompensate quickly with poor oral intake, vomiting, diarrhea, fever, or abdominal pain.
- Triage safety requires cue collection before discussing symptom-only medication requests.
- Red-flag symptom clusters should trigger urgent emergency department referral rather than delayed outpatient management.
- Clear communication and escalation rationale improve caregiver adherence and safety outcomes.
Equipment
- Standardized telephone triage script and documentation workflow
- Access to patient record for age and history verification
- Escalation pathway for provider notification and emergency referral documentation
Procedure Steps
- Verify caller identity, child identifiers, and immediate callback number.
- Clarify chief concern and establish symptom timeline (onset, frequency, progression).
- Screen for red flags: inability to retain fluids, prolonged vomiting, fever, abdominal pain, reduced intake, and signs of deterioration risk by age.
- Assess hydration-risk context, especially in children under age 2 with limited intake and ongoing losses.
- Avoid symptom-only closure (for example, antiemetic request) when high-risk cue cluster suggests possible serious illness or dehydration.
- Recommend emergency evaluation when severity or risk pattern exceeds safe home management.
- Use clear, direct language explaining why urgent evaluation is needed and what worsening signs to monitor en route.
- Notify on-call provider of referral and document triage cues, advice given, and caregiver response.
- Provide return-call instructions for any delay, transport barrier, or condition change.
Common Errors
- Treating medication request as the primary problem → delayed diagnosis of dehydration or other serious illness.
- Incomplete symptom timeline → underestimation of progression risk.
- Ambiguous escalation instructions → caregiver delay in seeking emergency care.
- Missing documentation of red flags and referral rationale → unsafe care continuity.
Related
- pediatric-dehydration-risk - Core risk framework for young-child fluid loss progression.
- patient-education-for-fluid-electrolyte-and-acid-base-risk - Reinforces caregiver warning-sign education.
- prevention-of-fluid-electrolyte-and-acid-base-imbalances - Early screening and intervention strategy.
- focused-assessment-for-fluid-electrolyte-and-acid-base-imbalance - Follow-up bedside assessment pathway after referral.
- intake-and-output - Key trend once in-person assessment begins.