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Nephrology & Internal Medicine · Patient Safety Tool

Symptom Checker — When Should You Worry?

Tick what you feel and your patient context, and get an instant triage recommendation: routine, within days, same-day, or emergency room now. Built for Filipino kidney, heart, and diabetes patients — runs entirely in your browser.

Author: W. G. M. Rivero, MD, FPCP, DPSN Approach: Conservative triage · err toward escalation Last ReviewedHuling Na-reviewKatapusang Na-reviewKarinan Na-review:
Filipino patient at home checking symptoms on her phone

How to Use This Tool

Tick first what describes you (on dialysis, diabetic, hypertensive, etc.), then tick the symptoms you feel right now. The recommended action updates in real time at the top of the tool. Scroll down for the full plan — what to do, what to bring.

1
Set your context Tick the boxes that apply: on hemodialysis, on peritoneal dialysis, CKD without dialysis, diabetes, hypertension, heart failure, recent transplant. The same symptom can mean very different urgency depending on your context.
2
Tick what you feel Go through each symptom and tap "Yes" if it applies. Some symptoms ask for more detail (severity, duration, how it started). The more accurately you describe what you feel, the better the triage.
3
Read the banner A colored banner above the tool shows the recommended action level. It updates instantly with every change. The strictest selected symptom wins — this tool errs on the side of caution.
4
Read the full plan Below the symptoms, the tool generates specific action steps and a "what to bring" list (your ID, PhilHealth, current meds, recent labs). Print it or screenshot it before you leave.

🚨 If you have crushing chest pain, severe difficulty breathing, sudden weakness on one side, seizure, or a major bleed — do not use this tool. Call 911 or go to the nearest emergency room now.

The Four Triage Bands

Every combination of symptoms and context is mapped to one of four bands. The strictest band wins — if you have one ER-level symptom and ten routine ones, the recommendation is ER.

Routine

Next visit

Mention at your next regular consultation. No new tests needed urgently.

Urgent

Within a few days

Schedule a visit within 2–3 days. Call your doctor's clinic to fast-track.

Same-day

Today

Same-day clinic, telehealth, or your dialysis unit. Don't wait until tomorrow.

ER now

Emergency room

Go to the nearest ER immediately. If you cannot drive, have someone bring you or call for help.

💡 Why "conservative" triage?
When the same symptom could mean two different things, this tool picks the more urgent one. Sending a worried-well patient to a same-day clinic is annoying but safe. Telling a real emergency to wait three days can be fatal. This bias is intentional and matches what your nephrologist would tell you over the phone.

The Symptom Checker

Tick your context, then tick what you feel. All data stays in your browser — nothing is sent to any server.

🟢 No urgent symptoms ticked yet Tick your context and symptoms below — the recommendation will update here.
1. Your Context
2. What You Feel Right Now

❤️ Heart & Breathing

Chest pain or pressureSqueezing, heavy, or radiating discomfort
When does it happen?
Any of these too?
Shortness of breath / hard to breatheFeeling of not getting enough air
How bad?
Orthopnea / sudden weight gainNeed to prop up on pillows to breathe, or +2 kg overnight
Which describes it?
Palpitations / irregular heartbeatHeart racing, fluttering, or skipping
Anything else?

💧 Urine & Kidneys

Change in how much urineMuch less, or none at all
How much in the last 12 hours?
Visible blood in urineRed, pink, or cola-colored urine
Anything else?
Foamy / bubbly urinePersistent foam that doesn't disappear

Foamy urine often means protein leak. Usually not an emergency but worth flagging for your next visit so a urinalysis can be checked.

🫧 Swelling

New or worse swellingFace, legs, hands, or abdomen
Where?

🤢 Stomach & Nerve Symptoms

Persistent vomiting or blood in vomit/stoolVomiting that won't stop, or black stools
Which?
Severe abdominal painWorst-ever or rapidly getting worse

⚠ For peritoneal dialysis patients, severe abdominal pain or cloudy PD fluid is peritonitis until proven otherwise — this is always an ER visit.

Severe headache, confusion, or seizureWorst headache ever, sudden confusion, new weakness, or convulsion

🌡️ Fever & General

Fever (≥38°C / 100.4°F)Measured temperature, not just feeling warm

⚠ Fever in a dialysis or post-transplant patient is treated as a serious infection until proven otherwise.

How high?
Fainted or near-faintedLost consciousness briefly, or felt about to

🍬 Diabetes Symptoms

Hypoglycemia signsShakiness, sweating, hunger, confusion, often before meals

First step: eat 15 g fast carbs (juice, soda, candy). Re-check sugar in 15 min. If still low or you can't keep fluids down, this becomes ER.

Very high sugar signs (DKA)Severe thirst, frequent urination, fruity breath, deep breathing, vomiting

DKA is always an emergency. Go to the ER even if you feel "mostly fine" — the danger is the metabolic state, not how you feel.

🩸 Dialysis-Specific

Problem with your dialysis accessAVF, AVG, or catheter
Missed your dialysis sessionSkipped a scheduled HD run
Done? Read the recommended plan below. To start over:
🟢
No urgent concerns yet
Tick your context and any symptoms you feel above. Recommendations will appear here.

What to Bring to the ER or Clinic

Whether you're going to the ER or a same-day clinic, bring these. It saves time and prevents repeated tests.

📋 Quick-grab checklist

  • Valid ID + PhilHealth MDR — for admission and Z-Benefit claims if applicable.
  • Current medication list with doses and times. Photo of the pill bottles is acceptable.
  • Most recent labs (last 1–3 months) — printout or PDF on your phone.
  • Dialysis log / record if on HD or PD — last 3 sessions' weights, BPs, and notes.
  • Doctor's name & contact — nephrologist or cardiologist if applicable.
  • This summary — print it or screenshot before you leave.

📞 Don't drive yourself
If you have chest pain, severe dyspnea, weakness on one side, confusion, or a seizure — call someone or call for transport. Sudden loss of consciousness while driving is dangerous for you and everyone on the road.

Important Limits of This Tool

Dr. W. G. M. Rivero

W. G. M. Rivero, MD, FPCP, DPSN

Specialist in Internal Medicine, Nephrology, and Clinical Nutrition. Practicing in Quezon City, Angeles City, and Marilao.Dalubhasa sa Internal Medicine, Nephrology, at Clinical Nutrition. Nag-eehersisyo sa Quezon City, Angeles City, at Marilao.Espesyalista sa Internal Medicine, Nephrology, ug Clinical Nutrition. Nag-practice sa Quezon City, Angeles City, ug Marilao.Dalubhasa sa Internal Medicine, Nephrology, at Clinical Nutrition. Nag-eehersisyo sa Quezon City, Angeles City, at Marilao.

PRC 0105184 · seriousmd.com/doc/williamrivero