Airway thresholds, first and always
Stridor, drooling, inability to swallow saliva, muffled voice, tripod positioning and rapidly progressive swelling end the call and produce emergency instructions immediately.
Specialty · ENT & Allergy
Airway first, then everything else about ears and noses.
ENT and allergy triage with airway and anaphylaxis thresholds on every contact, plus immunotherapy scheduling, hearing pathway coordination and post-tonsillectomy bleed protocols.
- < 30s
- Airway compromise to emergency advice
- 94%
- Immunotherapy visits kept on interval
- 2.6x
- Audiology pathway throughput
In the product
ENT line — post-operative call
EmergencyInbound 16:04 · Daniel P. · 7 · tonsillectomy day 7 · parent calling
Caller
He's spat out some blood twice in the last half hour. It's bright red. He seems alright in himself.
Post-tonsillectomy + fresh blood → secondary haemorrhage pathway, emergency
Primum
That needs to be seen now, even though he seems well. Take him straight to the emergency department — nothing to eat or drink from this moment, and sit him upright leaning forward.
Caller
Should I wait and see if it stops?
Primum
No. Bleeding at day seven can start again heavily and without warning. Go now. I'm alerting the ENT registrar that you're on your way.
Bleed protocol
- Procedure
- Tonsillectomy · day 7
- Bleeding
- Fresh, 2 episodes
- Airway
- Patent, no stridor
- Pathway
- Secondary haemorrhage
- Instruction
- Attend ED, nil by mouth
- ENT registrar
- Alerted 16:06
Emergency advice given · chart updated · department pre-notified
Overview
Two emergencies hide in a queue of very ordinary calls.
- Stridor, drooling, voice change and anaphylaxis features checked on every contact.
- Post-tonsillectomy bleeding runs its own protocol from the first mention of blood.
- Immunotherapy intervals, allergy test preparation and hearing pathways run on schedule.
An ENT and allergy list is mostly grommets, wax, hay fever and hearing aids. Buried in it are the two calls that cannot wait a minute: the airway that is closing, and the tonsillectomy patient who has started to bleed. Both often open with something that sounds routine.
Primum applies the airway and anaphylaxis thresholds to every contact before anything else happens, and runs the post-operative bleed protocol on any recent surgical patient. The rest of the specialty's work — immunotherapy scheduling, allergy testing preparation, audiology pathway coordination, vertigo triage — is protocolised and handled without a clinic slot.
Capabilities
Where ENT and allergy calls actually go wrong
Four protocols, two of which are time-critical.
Post-operative bleed protocol
Any blood after tonsillectomy or adenoidectomy triggers its own pathway: volume, timing, whether it is ongoing, and an unambiguous instruction to attend — secondary haemorrhage is treated as an emergency, not a question.
Immunotherapy kept on interval
Build-up and maintenance doses scheduled to protocol, with tolerability from the previous dose, intercurrent illness and beta blocker use all checked before the appointment is confirmed.
Hearing pathways coordinated
Audiology booking, aid fitting and repair, sudden sensorineural loss fast-tracked as the emergency it is, and tinnitus pathway triage with the questions that separate the urgent from the chronic.
How it works
Any ENT call, in order of danger
Airway, then bleeding, then the reason the patient rang.
- Arrives
- Decided
- Done
- Returned
01
Contact opens
Patient matched with recent procedures, allergy history, immunotherapy status and adrenaline auto-injector prescriptions loaded.
Surgical history loaded
02
Airway checked
The airway and anaphylaxis set evaluated before anything else, on every contact, whatever the stated reason for the call.
Airway set
03
Bleed protocol if relevant
Any recent ENT surgery plus any mention of blood opens the haemorrhage pathway with its own thresholds.
Post-op protocol
04
Programme or routing
Immunotherapy, audiology, vertigo or sinus pathway worked to completion, or routed with the findings coded and written back.
Chart write-back
01
Contact opens
Patient matched with recent procedures, allergy history, immunotherapy status and adrenaline auto-injector prescriptions loaded.
Surgical history loaded
02
Airway checked
The airway and anaphylaxis set evaluated before anything else, on every contact, whatever the stated reason for the call.
Airway set
03
Bleed protocol if relevant
Any recent ENT surgery plus any mention of blood opens the haemorrhage pathway with its own thresholds.
Post-op protocol
04
Programme or routing
Immunotherapy, audiology, vertigo or sinus pathway worked to completion, or routed with the findings coded and written back.
Chart write-back
Benefits
The dangerous calls surface, the routine ones leave the clinic
Both halves of the specialty get better at once.
Time-critical calls identified immediately
Airway compromise and post-operative bleeding are recognised in the first thirty seconds rather than at the end of a triage form.
Immunotherapy stops drifting
Missed intervals mean restarting build-up. Keeping patients on schedule protects both the outcome and the clinic's investment in it.
Audiology queues move
Booking, fitting, repair and follow-up handled by phone, so audiology capacity goes to assessment rather than administration.
In practice
Four ENT calls in one afternoon
The first two are emergencies that opened like routine enquiries.
Day 7 after tonsillectomy
Emergency, in 25sChild spat out fresh blood twice. Secondary haemorrhage pathway opens immediately with instructions to attend and nothing by mouth.
'My throat feels tight'
Anaphylaxis pathwayNut exposure twenty minutes earlier with a changing voice. Auto-injector instructions given and an ambulance recommended.
Hay fever, worse this year
Immunotherapy assessedCurrent treatment reviewed against your escalation ladder and an immunotherapy assessment booked.
Sudden hearing loss, 2 days
Fast-trackedUnilateral, sudden, no wax history. Treated as urgent and booked into a next-day slot rather than a routine audiology wait.
Read next
- PediatricsPediatric triage with age-specific red flags, weight-based dosing checks, immunisation catch-up and school-age illness advice — spoken to the adult who is actually holding the child.Open
- Emergency MedicinePost-discharge follow-up, results callbacks, ambulatory pathway coordination and the endless 'should I come in' calls — handled with emergency thresholds and an unambiguous bias toward being seen.Open
- Intelligent Triage & RoutingClinical triage against your own protocol, applied to every inbound contact — phone, portal message or web form — and routed to the pathway, the team and the timeframe your policy says it belongs in.Open
Test the two protocols that matter
Ask us to run airway compromise and post-tonsillectomy bleeding first. Everything else in this specialty is scheduling; those two are the reason the line exists.