Dental Emergency Triage

---
name: dental-emergency-triage
description: "Triage a dental emergency call so the right patient is seen today and the rest are safely scheduled — the red flags that are medical rather than dental, the questions that sort urgency, and the interim advice a receptionist can safely give. Use when asked to triage a dental emergency, decide who to fit in today, write phone triage guidance for front desk, or when a patient calls with swelling, trauma, or severe pain. Produces the urgency banding, the question script, the red-flag escalation list, interim self-care within scope, and the documentation line. Triage support only; never a diagnosis, and airway or spreading-infection signs go to emergency care immediately."
homepage: https://mohitagw15856.github.io/pm-claude-skills/skill/dental-emergency-triage.html
metadata:
  {
    "openclaw": { "emoji": "🧠" }
  }
---

# Dental Emergency Triage

The person deciding who gets today's emergency slot is usually the one with the least clinical training in the building. This gives them a script: the questions that separate a cracked cusp from a spreading infection, the handful of answers that mean stop booking and send them to hospital now, and the interim advice they can give without practising dentistry over the phone.

## What This Skill Produces

- **Urgency banding** — see now / see today / see within 48 hours / routine, with the finding that puts a call in each band
- **The question script** — the short ordered set that sorts most calls, in plain language a non-clinician can read aloud
- **Red-flag escalation** — the answers that mean emergency department, not dental chair, stated unambiguously
- **Interim advice within scope** — what front desk may safely say about pain, bleeding, and an avulsed tooth, and what they must not
- **The callback rule** — who is rung back by a clinician, and how fast
- **The documentation line** — what to record about the call, because triage decisions get reviewed

## Required Inputs

Ask for these if not provided:
- **What the patient reports** — pain, swelling, bleeding, trauma, a lost restoration, and how long it has been going on
- **The escalation signs** — whether there is facial swelling, difficulty swallowing or breathing, fever, or eye involvement
- **The context** — medical history if known, especially immunosuppression, anticoagulants, or diabetes; and whether they are an existing patient
- **Your capacity** — how many emergency slots exist today and who is on
- **Local escalation routes** — the out-of-hours service and nearest emergency department

## Framework: Rule Out the Medical Emergency, Then Band the Dental One

1. **Screen for airway and spread first.** Difficulty breathing or swallowing, swelling closing the eye or crossing the midline of the floor of the mouth, fever with rapidly spreading swelling — these are medical emergencies. Stop triaging and direct to emergency care.
2. **Then trauma with a time limit.** An avulsed permanent tooth is measured in minutes; this outranks pain.
3. **Then uncontrolled bleeding.** Especially post-extraction and especially on anticoagulants.
4. **Then pain, banded by what it tells you.** Keeping them awake, spontaneous, or lingering after cold suggests pulpal involvement and a today slot; pain only on biting or on sweet things usually holds.
5. **Then everything else.** Lost crowns, fractured teeth without pain, and orthodontic discomfort are genuinely uncomfortable and genuinely routine.
6. **Record the call either way.** What was reported, what band was assigned, what advice was given, and when they were offered.

## Output Format

### Triage: [caller] · [time] · taken by [staff]

**Reported:** [complaint in the caller's words, duration]

**Red-flag screen:** breathing/swallowing difficulty [Y/N] · swelling crossing midline or closing eye [Y/N] · fever with spreading swelling [Y/N] · uncontrolled bleeding [Y/N]
→ **Any yes: direct to emergency care now.** Record that this was done and the time.

**Band:** ☐ See now ☐ See today ☐ Within 48h ☐ Routine
**Reason for band:** [the specific finding]

**Interim advice given:** [only from the approved list — analgesia as per label, saline rinse, cold compress, bite on gauze for bleeding, keep an avulsed tooth in milk or saliva and come now]

**Appointment offered:** [date/time] · **Accepted:** [Y/N]
**Clinician callback:** [required Y/N · by when]

> Triage support, never diagnosis. This sorts urgency from a phone call; it does not establish what is wrong. Airway compromise, spreading infection, and significant trauma go to emergency medical care immediately. Adapt bands and scripts to your regulator's scope-of-practice rules for non-clinical staff.

## Quality Checks
- [ ] The medical red-flag screen runs before any dental banding
- [ ] Avulsed permanent teeth are treated as time-critical, ahead of pain
- [ ] Interim advice stays strictly within what non-clinical staff may say
- [ ] Every band has a stated reason recorded against it
- [ ] The out-of-hours and emergency-department routes are named, not implied
- [ ] The call is documented whether or not an appointment was made

## Anti-Patterns
- **Triaging on pain score alone.** The most dangerous presentations are often not the most painful ones.
- **Front desk offering a likely diagnosis.** 'Sounds like an abscess' is practising dentistry over the phone.
- **Missing the swallowing question.** It is the single most important question in the script.
- **Recommending a specific antibiotic or dose.** Never, and never on a phone call.
- **Not recording declined appointments.** A refused offer is the record that protects the practice.
- **Treating an avulsed tooth as a next-day problem.** The window is minutes to an hour.

## Example Trigger Phrases
- "Write phone triage guidance for our front desk"
- "A patient called with facial swelling — how urgent is this?"
- "How do we decide who gets the emergency slot today?"
- "What can reception safely tell a patient who has knocked out a tooth?"
- "Triage script for dental emergency calls"