- Home
- Urgent care
See, treat and safely discharge — in 30 minutes.
The urgent care conditions you see as an SHO or junior doctor, each laid out as one focused consult: red flags, focused history and examination, the decision rule, investigations only when they change the plan, the discharge prescription, safety-netting wording and NHS leaflet QR codes.
0–5Red flags + history5–12Examine12–17Decide17–24Treat + explain24–30Safety-net + document
Injuries & musculoskeletal8
Ankle & foot injuryTwisted ankle or foot — Ottawa rules decide the X-ray.⏱ 15 min · 🔬 X-ray only if Ottawa positiveKnee injuryTwisting or direct knee injury — Ottawa knee rule, spot the ACL and locked knee.⏱ 15–20 min · 🔬 X-ray only if Ottawa positiveWrist injury & scaphoidFall on the outstretched hand — distal radius vs scaphoid.⏱ 20 min · 🔬 X-ray wrist + scaphoid views if bony tendernessHand & finger injuryBoxer’s fracture, mallet finger, crush injuries and the hand you must not miss.⏱ 20 min · 🔬 X-ray if bony tenderness or deformityShoulder & collarbone injuryCollarbone fractures, ACJ injuries and the dislocated shoulder.⏱ 20 min · 🔬 X-ray if deformity or bony tendernessLow back painNon-specific back pain: rule out the red flags, then keep them moving.⏱ 15 min · 🔬 Usually noneNeck sprain & whiplashLow-speed collisions and neck sprains — Canadian C-spine rule.⏱ 15 min · 🔬 Imaging only if C-spine rule says soMinor head injuryWho needs a CT and who can go home with advice.⏱ 20 min · 🔬 CT head only if NICE criteria met
Wounds, burns & skin8
Lacerations & wound careClose it right, check tetanus, and know which wounds aren’t yours.⏱ 25–30 min · 🔬 X-ray only for glass / foreign bodyMinor burns & scaldsCool, cover, size it — and know when it goes to the burns unit.⏱ 20–25 min · 🔬 Usually noneHuman & animal bitesWho gets prophylaxis, rabies risk and the fight bite.⏱ 20–25 min · 🔬 X-ray if bone/joint involvement or tooth fragmentInsect bites, stings & tick bitesBig local reactions vs infection vs anaphylaxis — and Lyme.⏱ 10–15 min · 🔬 Usually noneCellulitisOral antibiotics at home or IV? Mark the edges and safety-net.⏱ 15–20 min · 🔬 Usually none (bloods if systemically unwell)Skin abscess & boilsDrain it — antibiotics are usually not the answer.⏱ 25–30 min · 🔬 Usually none (glucose if recurrent)Urticaria & allergic reactionsHives without airway or circulation problems — and when it’s anaphylaxis.⏱ 15 min · 🔬 Usually noneShinglesWho gets aciclovir, and the shingles you must send to eyes.⏱ 15 min · 🔬 Usually none
Ear, nose, throat & eyes7
Sore throat & tonsillitisFeverPAIN decides — and don’t miss the quinsy or epiglottitis.⏱ 10–15 min · 🔬 NoneEarache: otitis media & externaMostly no antibiotics — but spot mastoiditis and malignant otitis externa.⏱ 10–15 min · 🔬 NoneSinusitisViral until day 10 — and don’t miss the orbit.⏱ 10 min · 🔬 NoneNosebleed (epistaxis)Proper first aid, cautery if you can see it, and who needs ENT.⏱ 20 min · 🔬 Usually none (FBC/INR if heavy or anticoagulated)Red eye & conjunctivitisConjunctivitis is a diagnosis of exclusion — check acuity and pain first.⏱ 15 min · 🔬 None (acuity + fluorescein)Corneal abrasion & eye foreign bodyFluorescein, evert the lid — and never miss the penetrating injury.⏱ 20 min · 🔬 X-ray orbit if high-velocityDental pain & abscessAnalgesia and a dentist — antibiotics only for spreading infection.⏱ 10 min · 🔬 None
Infections & medical5
Cough & chest infectionBronchitis vs pneumonia, and the NICE rules on antibiotics.⏱ 15 min · 🔬 Usually none (CXR if pneumonia suspected)Lower UTIDiagnose on symptoms, choose by eGFR and pregnancy, spot pyelonephritis.⏱ 10–15 min · 🔬 Urine dip (women < 65); culture in men/pregnancyDiarrhoea & vomitingRehydrate, rule out the surgical belly and the C. diff, and keep them off work.⏱ 15 min · 🔬 Usually noneHeadacheScreen SNOOP, then treat tension and migraine well — and avoid opioids.⏱ 15–20 min · 🔬 Usually noneCalf pain & suspected DVTTwo-level Wells, D-dimer, scan within 4 h or anticoagulate.⏱ 25 min · 🔬 D-dimer ± ultrasound per Wells
Children1
Clinic toolkit
℞Adult analgesia quick reference
| Drug | Dose | Cautions |
|---|---|---|
| Paracetamol | 1 g every 4–6 h, max 4 g/24 h | Reduce if < 50 kg, liver disease, alcohol |
| Ibuprofen | 400 mg three times a day with food | Avoid: GI bleed, renal impairment, NSAID asthma, anticoagulants, pregnancy, heart failure |
| Naproxen | 500 mg twice a day with food | As above; consider PPI if GI risk |
| Topical NSAID (ibuprofen 5% gel) | Up to three times a day | Sprains/strains; fewer systemic effects |
| Codeine | 30 mg up to four times a day | Only if NSAID unsuitable; short course; constipation, drowsiness, driving; avoid in under 12s and breastfeeding |
Check the BNF. Children: weight-based doses per BNFc.
☂The safety-net formula
- What it is — the diagnosis in plain words
- What to expect — how long it lasts and what is normal
- What to do — treatment, and what not to do
- Warning signs — specific symptoms, not “if worse”
- Where to go — GP, 111, come back, or 999 — and when
- Check understanding — ask them to repeat it back; give the leaflet
Document the safety-netting you gave, word for word if you can.
⚖Decision rules in this section
💉Tetanus in one line
Fully immunised (5 doses) → no booster needed. Incomplete or unknown → give a tetanus-containing vaccine. For tetanus-prone wounds in someone not fully immunised, also consider human tetanus immunoglobulin, and give it for high-risk wounds. Use the UKHSA Green Book, chapter 30 table.