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NHS Pathways system update - clinical release note - release 46.2.0

Release 46.2.0 was made available to suppliers and providers on 23 December 2024.

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NHS Pathways make changes to content based on new or emerging clinical evidence, change requests, and feedback from our providers or wider stakeholders. 

NHS Pathways identifies areas of content that would benefit from enhancement. The aim of these enhancements is to provide clarity for users, and to benefit both users’ and patients’ experiences, thus ensuring that triage is as safe, effective, and efficient as possible. 

The enhancements to Main Telephony made by NHS Pathways for Release 46.2.0 are highlighted below. Release 46.2.0 was made available to suppliers and providers on 23 December 2024.

What we've changed

Button Battery Ingestion care advice update

NHS Pathways have amended the care advice for Button Battery Ingestion for children under and over the age of 12 months.

The following changes were made
  • Advice for children over the age of 12 months previously stated that honey could be administered to neutralize the alkaline injury caused by a button battery. This has been updated to advise either honey or jam can now be given.
  • Infants over the age of 6 months are advised to be given jam. Care advice was not previously available for children under the age of 12 months due to honey not being suitable.

Abdominal Pain Under 35s

NHS Pathways have enhanced the assessment for patients with a main symptom of abdominal pain, vomiting and/or nausea with abdominal pain, or rectal bleeding with abdominal pain.

The following changes were made
  • Under 35's with a main symptom of abdominal pain, vomiting and/or nausea with abdominal pain, or rectal bleeding with abdominal pain will no longer be presented with the acute coronary syndrome/severe chest pain question and will continue their triage in critical illness/abdominal pain pathways. Triage is unchanged for people with Marfan syndrome, and they will be asked about associated severe chest pain. This ensures the most appropriate questioning and dispositions for this age-group.

Septicaemic Rash - amendment to the ‘not sure’ routing

NHS Pathways have reviewed the triage for suspected septicaemic rash throughout the system.

The following changes were made
  • Patients who answer ‘not sure’ to the question ‘Have you developed one or more new marks, like bruising or bleeding under the skin?’ now follow the same triage route as those who answered ‘no’. Previously these patients followed the same triage route as patients who answered ‘yes’ to this question. This is to ensure people with these potential symptoms are routed to the appropriate triage.

Cauda Equina Syndrome, update to ‘Loss of Bowel Control’ pathway

Continuing work completed in R45.2.0, NHS Pathways have further reviewed how adults and children with suspected Cauda Equina Syndrome (CES) are triaged within the ‘Loss of Bowel Control’ pathway.

Changes have been made to align with assessment of cauda equina in other pathways and also prevent duplication of back pain questions for those transferring into diarrhoea or constipation pathways:

The following changes were made
  • In the ‘Loss of Bowel Control’ pathway, the first question ‘Have you got pain in the lower back?’ has been removed, and therefore the first question is now ‘Have you got new inability to control the bowels?’ 
  • Patients with new inability to control bowels who later answer yes to back OR leg pain and answer ‘yes’ to the question ‘Is there someone who can safely take the individual to hospital?’ will receive a ‘Refer to Treatment Centre within 1 hour’. If they answer ‘no’ they will receive a Category 3 ambulance disposition.

Adrenaline Auto Injectors

Continuing work completed in R45.2.0, changes were made to Adrenaline Auto Injectors (AAIs) content.

The following changes were made
  • It was noted that local authority maintained nursery schools can purchase AAI’s. As a result, nursery schools have been added to the question wording.

Additionally, the following populations can now be assessed to see if they should reach the AAI advice:

  • Toddlers, adults and children who are unconscious and have declared an allergic reaction.
  • Toddlers, adults and children with noisy breathing who have had a previous severe allergic reaction.

Last edited: 17 December 2024 12:32 pm