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Screening red flags

The triage framework that decides what happens after a questionnaire comes back. This page is for the coach, not the client.

Not clinical guidance

These thresholds are a reasonable default for a general fitness setting, assembled to show how the questionnaire's answers map to actions. They are not clinical guidance and they are not a substitute for the standards of your professional body, your insurer or your local regulator. Have them reviewed and adjusted before use, and when in doubt, refer.

The specifics live with the questions, not here

The actual trigger list — which answer means what, and which field ID drives it — is copied in full at the end of every section page, in that page's own "Red flags" subsection. For example, see 4.2. This page defines only the outcomes those triggers feed into and the rules that apply regardless of which section is running.

Keeping the specifics on the section page means whoever — or whatever — is asking that section's questions can recognise a trigger the moment it is said, without a separate reference open at the same time.

Triage outcomes

Outcome Meaning Action
Clear No flags Proceed to assessment and programming
Proceed with caution Manageable flags Programme with documented modifications; note the reasoning
Clearance required Needs a clinician's sign-off first No exercise testing or programming until written clearance is on file
Refer & stop Potentially urgent Do not train. Direct to a doctor or emergency services as appropriate

How the outcome is reached

A flag can come from any section — the questionnaire does not confine risk information to one place, so triage does not either.

  • Any flag anywhere pushes toward the more cautious outcome, never the less cautious one. A single Refer & stop flag overrides every other finding in the record, however clear the rest of it is.
  • The more serious of two conflicting answers wins. If the same risk is asked about twice in different words and the answers disagree, treat the more serious one as authoritative rather than averaging or picking the first.
  • A flag is recorded even when the decision is to proceed. The reasoning for proceeding despite a flag is exactly what a later reviewer — or a regulator — will ask to see.

Record the flag itself, not just the outcome: which field triggered it, its value, and which outcome it points to. See the handover record for the exact format.

During any session

Stop the session, regardless of what the paperwork said:

  • Chest pain or pressure
  • Dizziness, light-headedness or confusion
  • Unusual shortness of breath
  • Pale, grey or clammy appearance
  • Irregular or racing heartbeat
  • Sharp joint pain, or any pain that changes movement quality
  • Anything the client describes as "not right"

Record the decision either way

Log the triage outcome against the client's record, with the date, the fields that drove it, and who made the call. If a flag was found and the decision was to proceed, that reasoning is the thing you will need later.