History

HPI overview

Throat pain characterization

OPQRST

Onset:

Provocation or palliation:

Quality:

Region or radiation:

Severity:

Timing:

Associated symptoms

Infectious features

Airway and voice features

Deep space infection features

GI features

Rash and systemic features

Exposures and context

Transmission context

Ingestion and caustic risk

Foreign body risk

Sexual exposure context

Prior episodes and baseline

Prior similar episodes

Baseline airway risk

Alarm Features

Airway threat

Airway compromise features

Deep neck space infection red flags

Deep space infection red flags

Vital sign danger thresholds

Physiologic instability thresholds

High risk populations

High risk patient factors

Immediate escalation triggers

Escalation logic

Medications

Current medications

Medication reconciliation

OTC and symptomatic therapies

OTC exposures

Medication related injury risk

Pill esophagitis risk medications

Allergy and interaction traps

Medication safety

Diet

Intake and hydration

Oral intake status

Trigger foods and reflux pattern

Reflux associated exposures

Caffeine and alcohol

Stimulant and alcohol exposure

Review of Systems

Constitutional

Systemic symptoms

HEENT

Head and neck symptoms

Respiratory

Lower airway symptoms

GI

Esophageal and gastric symptoms

Skin and MSK

Inflammatory features

Neuro

Neurologic red flags

Collateral History and Family History

Collateral and reliability

Source and reliability

Family history relevant to throat pain

Familial conditions

Household and community exposures

Exposure context

Risk Factors

Infectious risk factors

Infection risks

Deep neck infection risk factors

Deep space infection risks

Thrombotic and Lemierre risk

Lemierre syndrome risks

Malignancy risk factors

Neoplastic risks

Immunocompromised states

Host defense impairment

Differential Diagnosis

Life threatening

Cannot miss airway and deep space causes

Common

High frequency diagnoses

Less common

Less common and special causes

Mimics and pitfalls

Mimics and diagnostic traps

Past Medical History

Conditions affecting risk and management

Relevant chronic conditions

Prior ENT and dental history

ENT and dental history

Procedures and devices

Prior procedures

Baseline function and airway

Baseline considerations

Physical Exam

General and vitals

General assessment

Vital signs pattern

HEENT focused

Oropharynx and oral cavity

Neck exam

Ear exam

Respiratory and cardiovascular

Chest assessment

Hemodynamic signs

Skin and neuro

Rash and mucosa

Neurologic status

Lab Studies

Infectious testing

Targeted microbiology

Bloodwork for severe illness

Severity and sepsis labs

EBV and other specific labs

Alternative etiology tests

Chemistry and complications

Metabolic and organ assessment

Imaging

Scoring Systems

Pretest probability and antibiotics decision tools

MRI

MRI indications

MRI cautions

CT

CT neck with IV contrast

CT cautions

Ultrasound

POCUS applications

Ultrasound pitfalls

Special Tests

Bedside and procedural diagnostics

Airway visualization and procedures

Abscess specific tests

Esophageal evaluation

Esophageal focused testing

ECG

When ECG matters in throat pain

ECG triggers

High risk ECG findings

ECG red flags

Assessment

Problem representation

Syndrome framing

Working diagnosis and severity

Working diagnosis candidates

Complications to exclude

Complication screen

Plan

First 5 minutes

Immediate priorities

Analgesia and symptom control

Pain and fever control

Topical therapies

Antibiotics decision pathway

Suspected GAS management local protocol dependent

Adult antibiotic examples

Penicillin allergy alternatives

Deep neck infection management

Suspected peritonsillar abscess

Suspected retropharyngeal abscess or Ludwig angina

Reassessment loop

Reassessment timing

Disposition

ICU criteria

ICU indications

Inpatient admission criteria

Admission indications

Observation pathway criteria

Observation candidates

Discharge criteria

Safe discharge requirements

Discharge Instructions

Copy discharge instructions

Summary:

Medications:

Hydration and diet:

Activity:

Follow up:

Return to ED now if:

References

Guidelines and key sources

Evidence based references

Project instructions source