You are at an ED triage desk and you need to make quick, safe decisions based on the information you can get in a short interaction. The patient is uncomfortable and uses everyday language that could mean different things. Your goal is to clarify the symptoms, check for red flags, and document the most important details clearly.
You will practise language that keeps you in control while still showing empathy: short questions, clear options, and calm reassurance. You will also work on safely checking numbers and timings (when it started, how long it lasts, how often it happens). A key focus is reducing risk without causing panic: asking about warning signs in a neutral way, and explaining why you need to ask. You end the lesson by summarising the triage outcome: what will happen next and what the patient should do immediately if their symptoms change while they wait.
1. Arriving at the ED triage desk.
You’re at the ED triage desk. In real life, you often have only a few minutes to work out what’s going on, what might be serious, and what information you must document clearly. In this lesson, we’ll stay with one patient from start to finish, and your goal is to clarify vague everyday symptom language, check red flags calmly, confirm times and numbers, and then explain what happens next.
In this first step, I want you to listen to a short model triage interaction. Notice how the clinician keeps a warm tone but uses short, controlled questions. Also notice the safety lines: ‘I’m asking these questions to make sure we don’t miss anything serious.’ That one sentence helps you ask direct red-flag questions without alarming the patient.
As you listen, don’t try to understand every word. Focus on four things: the patient’s main symptoms, when they started, any red flags mentioned, and what the clinician says will happen next. After that, you’ll answer a few comprehension questions and I’ll help you tighten the details.
The situation.
You are the triage clinician. The waiting room is busy. The patient looks uncomfortable and is using everyday language that can mean different things.
Your job at triage is not to give a full diagnosis. Your job is to get a safe, accurate snapshot:
What is the main problem today?
When did it start and how has it changed?
Are there any warning signs (red flags)?
What do we do next, and what should the patient do if things change while they wait?
What “good” sounds like at triage.
At B2 level, the key skill is controlled clarity. You want to sound calm and kind, but you also need to sound structured.
Here are phrases you will hear in the model:
“Can you show me exactly where the pain is?”
“When you say ‘dizzy’, do you mean the room is spinning or you feel faint?”
“Just to confirm, this started this morning at about…?”
“I’m asking these questions to make sure we don’t miss anything serious.”
Listening goal.
While you listen, try to capture four anchors:
Main symptom(s) (in the patient’s words and in your clinical wording)
Timing (start time, duration, frequency)
Red flags asked about (what the clinician checked)
Next steps (what happens after triage)
In the activity below, write short answers. Accuracy matters more than long sentences.
Practice & Feedback
Listen to the triage audio and answer these questions in short, clear notes (not full paragraphs).
What are the patient’s two main symptoms?
When did the symptoms start (time and/or part of the day)?
Name two red-flag areas the clinician checks (for example: chest/breathing, neurological symptoms).
What does the clinician say will happen next?
Write 1–2 lines per answer. If you are not sure of a detail, write your best guess and mark it with a question mark. We’ll improve it together.
2. Clarifying vague symptoms with options.
Now let’s zoom in on the hardest part of triage English: everyday words that can mean several different clinical realities. “Dizzy” is a perfect example. Some patients mean vertigo, the room spinning. Others mean light-headedness, like they might faint. Those two meanings lead you down very different safety pathways, so you must clarify, but you must do it without sounding like an interrogation.
The simplest technique is to offer two clear options in plain English, and then ask one extra detail. For example: “Do you mean the room is spinning, or you feel faint?” Then, once you’ve got the type, you can check frequency and triggers: “Is it constant, or does it come and go?” and “What brings it on?”
In this block, you’ll read short patient statements and choose the best clarification question. Aim for questions that are short, calm, and easy to answer. You’re keeping the patient safe and keeping the queue moving.
Why options work at triage.
Patients often use one word for many experiences: dizzy, tight, numb, weak, funny, not right. If you ask a broad question like “Can you describe that?”, you may get a long, messy story. At triage, you need a faster tool.
A reliable pattern is:
Mirror the patient’s word (so they feel heard)
Offer two or three options in everyday language
Ask one targeted follow-up (timing, trigger, severity)
Model patterns you can reuse.
Dizzy
“When you say ‘dizzy’, do you mean the room is spinning, or you feel faint?”
“Do you feel unsteady on your feet, or more light-headed?”
Chest symptoms
“When you say ‘tight’, is it like pressure, like someone sitting on your chest, or more like a sharp pain?”
“Is it constant, or does it come and go?”
Shortness of breath
“Is it only when you walk, or even at rest?”
“Can you speak in full sentences, or do you have to pause for breath?”
Micro-skill: keep it calm.
If you need to ask direct questions, add a neutral reason:
“I’m asking these questions to make sure we don’t miss anything serious.”
That sentence reduces panic and reduces resistance.
Your task.
You’ll see four short patient statements. For each one, write the best next question using the option style above. Keep each question to one line.
Practice & Feedback
Read the four patient statements below. Imagine you are at the triage desk with Mr Khan. For each statement, write one best clarification question.
Rules:
Write 4 questions (label them 1–4).
Use the options technique at least twice (A or B).
Keep a calm, professional tone.
Stay in triage mode: short questions, quick clarity.
Example style: “When you say ‘dizzy’, do you mean the room is spinning or you feel faint?”
After you write, I’ll correct and upgrade your questions to make them smoother and more patient-friendly.
Patient: “I’m dizzy.”
Patient: “My chest feels tight.”
Patient: “I can’t catch my breath.”
Patient: “I feel weak.”
3. Asking about red flags without alarming the patient.
Next, we’ll practise the red-flag section. This is where many international clinicians either sound too frightening or too vague. The aim is a calm, neutral checklist, not dramatic language. You can keep your voice steady, use simple medical categories, and give a clear reason for asking.
Notice the difference between “Are you having a stroke?” and “Any weakness, slurred speech, or changes in vision?” The second version is more specific and less scary. It also helps the patient answer more accurately.
We also need to be very careful with time and numbers. “Half nine” and “nine thirty” can be misunderstood. So we confirm: “Just to confirm, this started at about 9.30 this morning, is that right?” Then we can ask about episodes: how long each one lasts, and how often it happens.
You’ll listen to a second mini-audio where the clinician checks red flags and timing. Then you’ll write the exact red-flag questions you would ask next.
Red flags: calm language, clear categories.
At triage, red-flag questions are about risk reduction. Your wording should be:
specific (so the answer is useful)
neutral (so the patient doesn’t panic)
brief (so you can cover the essentials)
Useful chunk bank for this stage.
You’ll reuse these patterns again and again:
“Have you had any chest pain or shortness of breath?”
“Any weakness, slurred speech, or changes in vision?”
“Have you fainted at all today?”
“Is the pain constant, or does it come and go?”
“Just to confirm, this started this morning at about…?”
“I’m asking these questions to make sure we don’t miss anything serious.”
Timing checks that prevent errors.
Patients often give vague timelines:earlier, this morning, a while ago, for ages. Convert that into something you can document:
Start time: “What time did it start?”
Duration: “How long does each episode last?”
Frequency: “How many times has it happened today?”
If you’re not sure you heard correctly, it’s safer to repeat back:
> “Just to confirm, it started at about 9.30 this morning, and it comes and goes. Is that right?”
What you will do now.
After the short listening, you’ll write:
Two neurological red-flag questions
Two chest/breathing red-flag questions
Two timing questions (start time and episodes)
Keep them short. Aim for the patient to answer with a simple “yes/no” or a number/time.
Practice & Feedback
Listen to the short audio. Then write 6 triage questions you would ask Mr Khan next.
Write them under these headings:
Neuro red flags (2 questions)
Chest/breathing red flags (2 questions)
Timing and numbers (2 questions)
Use calm, neutral language. Include the safety line “I’m asking these questions…” once (you can place it before the red-flag questions). Keep each question on its own line, with a question mark.
After you write, I’ll correct grammar and make your questions sound more natural in spoken ED English.
4. Turning the conversation into clear triage notes.
You’ve clarified the symptom language and covered key red flags. Now we need to turn that spoken, messy information into a short triage record that another colleague can read quickly. This is where many errors happen: missing times, unclear wording like “dizzy”, or mixing the patient’s words with your interpretation.
A safe approach is to document in compact lines: main complaint, onset, nature, associated symptoms, negatives, and what you did next. You can include the patient’s wording in quotation marks if it matters, and then add your clarified meaning. For example: “Pt reports ‘dizzy’ clarified as light-headed/faint, not room spinning.”
In this block you’ll read a draft triage note that has common problems: vague timing, unclear symptoms, and missing negatives. Your job is to improve it. Keep it brief, but make it safe. Imagine a colleague has to make decisions based on your note two hours later. They should not have to guess what you meant.
From spoken English to patient-safe documentation.
Triage notes need to be readable at speed. Your colleague should be able to answer these questions in under ten seconds:
Who is the patient and why are they here?
When did it start?
What key red flags were checked, and what were the answers?
What happens next?
A simple structure (works in almost any ED).
You can use this mini-template:
CC (chief complaint): main symptoms in a few words
Onset: date/time + how it behaves (constant / intermittent)
Associated symptoms: e.g., SOB on exertion
Negatives (red flags denied): neuro, chest, fainting, etc.
Plan at triage: obs, ECG, clinician review, waiting advice
Example: strong, compact wording.
> “CC: Intermittent light-headedness (near-syncope) + central chest tightness/pressure. Onset ~09:30 today. Episodes last ~5 mins. SOB on exertion. Denies syncope, neuro deficit (no weakness/slurred speech/visual change). Plan: obs + ECG; advised to alert staff immediately if worsening CP, SOB at rest, or near-faint.”
Notice what makes it safe:
clear time (“~09:30 today”)
clarified meaning (light-headedness, not ‘spinning’)
specific negatives (not just “no red flags”)
a clear next step
Your editing task.
Below is a draft note. It’s understandable, but it’s not safe enough. Improve it by:
adding the missing time/behaviour details
clarifying “dizzy”
adding at least two specific negatives
keeping it brief (aim: 4–6 lines)
Practice & Feedback
Read the draft triage note. Rewrite it as a clearer, safer note for Mr Khan.
Guidelines:
Aim for 4–6 short lines.
Include: symptom clarification, onset time, intermittent/constant, at least two specific red-flag negatives, and what you arranged next.
Use neutral, factual language (no dramatic adjectives).
You can use abbreviations like SOB (shortness of breath) if you like, but keep it readable.
After you write, I’ll: (1) correct language, (2) suggest a tighter structure, and (3) give you a model version you can compare with yours.
Draft triage note (needs improvement):
“Samir Khan came in feeling dizzy and tight chest. Started this morning. Comes and goes. A bit breathless. No stroke symptoms. Will wait for next step.”
5. Chat-style triage follow-up with the patient.
Let’s make this feel more like a real shift. You’ve got the key information, but triage often needs one more short loop: you confirm details, check one or two additional risk questions, and keep the patient calm while you arrange observations and the next step. You also have to manage expectations: you can’t promise exact waiting times, but you can explain priorities and what to do if symptoms change.
In this block we’ll do a short chat-style simulation. You are the triage clinician. I will play the patient, Mr Khan. Your job is to write brief messages as if you’re speaking: one or two sentences each time, not long paragraphs. Use the language we’ve practised: options for clarification, calm red-flag checks, and confirmation of times and numbers.
Remember: you’re in control of the structure. If the patient gives a long answer, it’s fine to politely interrupt and narrow it down. Also, don’t forget the safety line: you ask these questions to avoid missing anything serious. After your messages, I’ll give you feedback and a stronger version that sounds natural in UK ED triage.
Simulation rules (like a mini OSCE).
This is a written chat, but imagine it’s spoken at the triage desk.
Your goals in the conversation:
Confirm identity and timing (quickly)
Clarify the symptom meaning (especially “dizzy” and “tight”)
Check key red flags (neuro and chest/breathing)
Summarise back what you have understood
Explain next steps and waiting advice in a calm way
Language to keep ready.
Here are “high-value” lines you can drop in when needed:
“Just to confirm, this started at about 9.30 this morning, is that right?”
“When you say ‘dizzy’, do you mean the room is spinning or you feel faint?”
“I’m asking these questions to make sure we don’t miss anything serious.”
“At the moment, you’re safe to wait, but please tell us immediately if…”
“I’m going to note this down and arrange the next step.”
How to write your chat messages.
To keep it realistic:
Write 4 messages as the clinician.
Each message should be 1–2 short sentences.
Use at least one clarification-with-options question.
Use at least one red-flag question.
Include one brief summary line near the end.
The patient’s messages will be provided below. You respond as the clinician after each one.
Practice & Feedback
Chat simulation: reply as the triage clinician.
You will see 4 patient messages. Write 4 clinician replies, one after each patient message. Keep your replies short (1–2 sentences each), calm, and structured.
Must include:
a time confirmation (e.g., 9.30 this morning)
one options-style clarification question
one red-flag check question
one short summary + next step
Write your answers in this format:
Clinician: …
Clinician: …
Clinician: …
Clinician: …
After you write, I’ll correct and suggest a more natural UK ED version.
Patient message 1: “Hi… I’m Samir. I’ve been feeling dizzy since this morning.”
Patient message 2: “It’s not spinning, it’s like I might collapse. And my chest feels tight.”
Patient message 3: “It comes and goes. I get a bit out of breath when I walk to the toilet.”
Patient message 4: “I’m worried it’s something serious. How long will I have to wait?”
6. Summarising the triage outcome and safety advice.
You’ve done the hard work: you clarified vague symptoms, checked red flags without causing panic, and captured the details in a triage note. The final step is often forgotten, but it’s crucial for safety: you summarise what you’ve understood and you give clear instructions for what happens next.
At triage, you need to balance reassurance and caution. You can say, “At the moment, you’re safe to wait,” but you must add the conditions: “Please tell us immediately if…” This is safety-netting in real time.
In this final task, you’ll write two short pieces. First, a patient-facing summary: two or three short paragraphs in plain English, telling Mr Khan what you’ve noted, what you’re doing next, and what to watch for while waiting. Second, a compact clinician-facing triage summary line that could go into the record.
Aim for calm, precise language, with the key numbers and timings included. This is your capstone performance for the lesson: a complete triage outcome that is safe, clear, and human.
Closing triage safely: what you say matters.
Even when you are very busy, a clear closing can prevent harm. Patients in pain or anxiety may not remember details unless you make them simple and repeat the key points.
A strong triage closing usually has three parts:
Summary back (so errors are caught)
Next step (what you will do now)
Safety advice while waiting (what to do if symptoms change)
Patient-friendly model (adapt to the person).
Here is a model you can adapt. Notice how it avoids dramatic language but is still very clear:
> “So, just to summarise, you’ve had episodes of feeling light-headed, like you might faint, since about 9.30 this morning, and you’ve also had central chest tightness. It comes and goes, and you get a bit short of breath when walking.”
>
> “I’m going to note this down and we’ll check your observations and do an ECG. That will help us decide the next step.”
>
> “At the moment, you’re safe to wait. Please tell us immediately if the chest tightness gets worse, you become very short of breath, you faint, or you feel suddenly weak or unwell in a new way.”
Mini rubric (self-check).
Before you submit your writing, quickly check:
Clarity: Would a non-medical person understand?
Specificity: Have you included time and episode length?
Safety: Have you listed clear “tell us immediately if…” warnings?
Tone: Calm, respectful, not dismissive.
Your final performance.
You will write:
A) A patient-facing triage outcome message (plain English)
B) A one-line clinician-facing triage summary
Keep both rooted in the same facts from Mr Khan’s case.
Practice & Feedback
Final writing task (capstone): write two parts.
Part A (patient-facing): 90–130 words. Speak directly to Mr Khan in plain English. Include:
a short summary of symptoms + timing (9.30 today, comes and goes, ~5 minutes)
what you will do next (observations, ECG, clinician review)
what to do while waiting (clear safety advice: “please tell us immediately if…”) with at least 3 warning signs
Part B (clinician-facing): 1 line, like a triage summary note.
After you write, I’ll correct language, upgrade phrasing using the chunk bank, and give you a polished model version to compare.
Case facts to use (Mr Samir Khan):
Symptoms: light-headed/near-faint (not room spinning) + central chest tightness/pressure
Onset: ~09:30 today
Pattern: intermittent; episodes last ~5 minutes
Associated symptom: slight shortness of breath on exertion
Red flags asked: denies weakness/slurred speech/visual change; no full faint
Plan: triage documentation, observations, ECG, next clinical step
Safety-netting: alert staff immediately if worsening chest pain, very short of breath (especially at rest), fainting/near-faint, or new neurological symptoms
