Red Flags, Yellow Flags, Blue Flags, Black Flags

    red-fish-blue-fish.jpg

This page updated February 22, 2013.  

The other day a student asked me where the phrase “red flag” originated. He had also heard of yellow flags, and suspected that there were other colours of flags to indicate barriers to recovery. Well, we looked in various glossaries of medical and medical education terms, without success. So I e-mailed Dr. Shawn Thistle, and, sure enough, he helped. It is difficult to find where these terms originated (try Googling blue flags!) and Shawn thinks they may just be part of every doctor’s vocabulary. (Ever since I wrote the title above, I can’t get Dr. Seuss’s One fish two fish red fish blue fish out of my head.)

flags


Red flags/clinical red flags (biomedical factors) ~
These help identify potentially serious conditions, and are often listed in practice guidelines. Here is a description from Chapter 13 of the
Clinical guidelines for chiropractic practice in Canada [Glenerin Guidelines]:
The main focus for the prevention of complications is the recognition of well-known and established indicators or “red flag” signs and symptoms which may require careful assessment and reassessment, changes in treatment plan, or other appropriate action, such as emergency care or referral to another health care specialist. Ignoring these “red flag” indicators increases the likelihood of patient harm. 


Yellow  flags/clinical yellow flags (psychological or behavioural factors/predictors) ~
These indicate psychosocial barriers to recovery. Here is a definition from

New Zealand acute low back pain guide: incorporating the Guide to assessing psychosocial yellow flags in acute low back pain:
Yellow Flags are factors that increase the risk of developing or perpetuating long-term disability and work loss associated with low back pain … Before proceeding to assess Psychosocial Yellow Flags it is important to differentiate between acute, recurrent and chronic presentations. Evidence suggests that treating chronic back pain as if it were a new episode of acute back pain can result in perpetuation of disability. 


Blue flags/occupational blue flags (social and economic factors) ~
These refer to conditions in the workplace that may inhibit recovery. Examples are
monotony, low degree of control, poor relationships or high work demands. 


Black flags/socio-occupational black flags (occupational factors) ~
These are also used for workplace issues, but refer to organizational issues such as financial reliance on disability benefits, workers’ compensation issues, or employer attitudes to the sick worker.


References:
Helliwell PS, Taylor WJ. Repetitive strain injury. Postgrad Med J 2004;80(946):438-43.See An Approach to Diagnosis
Main CJ, Williams AC.  ABC of Psychological Medicine. Musculoskeletal pain. BMJ 2002;325(7363):534-7.
 


Click on the image below for The clinical flags approach to obstacles to recovery from back pain and aspects of assessment.

From:  Main CJ, Williams AC.  ABC of Psychological Medicine. Musculoskeletal pain. BMJ 2002 Sep 7;325(7363):534-7. PMC version

flags.gif 

32 Responses

  1. Interesting. Often terms in everyday use become used in medical training, initially I suspect as an analogy to explain a concept simply. Actually I thought the red-flag originated in the early 1900’s when those dangerous new inventions ‘motor cars’ were always preceeded along a road by a man carrying a red-flag!

  2. I read this post fully regarding the difference of newest and previous technologies, it’s awesome article.

  3. Greetings from Florida! I’m bored at work so I decided to browse
    your site on my iphone during lunch break. I enjoy the knowledge you present here and can’t wait to take a look when I get home.
    I’m shocked at how fast your blog loaded on my phone .. I’m not even using WIFI, just 3G
    .. Anyways, fantastic site!

  4. Do you have a spam problem on this blog; I also am a blogger, and I was curious about your situation; many of us have created some
    nice practices and we are looking to exchange solutions with others, please shoot me an email if interested.

  5. Wonderful website you have here but I was wondering if you knew of any forums that
    cover the same topics talked about here? I’d really love to be a
    part of group where I can get comments from other knowledgeable individuals that share the same interest.
    If you have any recommendations, please let me know.
    Thank you!

  6. I savour, result in I discovered just what I was taking a
    look for. You have ended my four day long hunt!
    God Bless you man. Have a great day. Bye

  7. I blog often and I really thank you for your
    information. This article has really peaked my interest.

    I am going to bookmark your blog and keep checking for new details about once per week.
    I opted in for your RSS feed as well.

  8. You can definitely see your enthusiasm in the work you write.
    The arena hopes for even more passionate writers such as you who are not afraid to say how they believe.
    All the time go after your heart.

  9. Hello, I wish for to subscribe for this web site to take most up-to-date updates, thus where can i do it please assist.

  10. I have read a few excellent stuff here. Definitely worth
    bookmarking for revisiting. I wonder how so much attempt you
    set to create this type of magnificent informative web site.

  11. I’m impressed, I must say. Seldom do I encounter a blog that’s both educative and entertaining,
    and without a doubt, you have hit the nail on the head.
    The problem is something that not enough folks are speaking intelligently about.
    I am very happy that I found this in my hunt for something regarding this.

  12. Hi there! I could have sworn I’ve been to this web site before but
    after looking at some of the articles I realized it’s
    new to me. Nonetheless, I’m certainly delighted I stumbled
    upon it and I’ll be bookmarking it and checking back regularly!

  13. Pretty section of content. I just stumbled upon your
    website and in accession capital to assert that I get in fact enjoyed account your blog posts.
    Any way I will be subscribing to your augment and even I achievement you access consistently rapidly.

  14. I know this website presents quality dependent content and additional stuff, is there any other web site which presents
    these kinds of things in quality?

  15. I’ve been exploring for a little for any high quality articles or blog posts in this sort of space
    . Exploring in Yahoo I at last stumbled upon this website.
    Reading this info So i am glad to express that I’ve an incredibly just right uncanny
    feeling I came upon exactly what I needed. I so much certainly
    will make sure to do not disregard this web site and give it a glance on a continuing basis.

  16. It’s remarkable to pay a quick visit this
    web page and reading the views of all friends regarding this paragraph, while I am
    also keen of getting knowledge.

  17. Hello to every single one, it’s really a fastidious for me to
    pay a quick visit this website, it consists of useful Information.

  18. What’s up, just wanted to say, I liked this article. It was practical.
    Keep on posting!

  19. hey there and thank you for your info – I’ve certainly picked up
    something new from right here. I did however expertise some technical points using this site, since I experienced to reload the website
    lots of times previous to I could get it to load correctly.
    I had been wondering if your hosting is OK?
    Not that I’m complaining, but slow loading instances times
    will very frequently affect your placement in google and could damage your quality score if advertising and marketing
    with Adwords. Well I am adding this RSS to my e-mail and could look out for much more of your respective interesting content.

    Ensure that you update this again soon.

  20. Hi there! I just wanted to ask if you ever have any issues with hackers?
    My last blog (wordpress) was hacked and I ended up losing
    many months of hard work due to no data backup.
    Do you have any methods to stop hackers?

  21. This design is incredible! You obviously know how to keep a reader amused.

    Between your wit and your videos, I was almost moved to start my own blog (well, almost…HaHa!) Wonderful job.

    I really loved what you had to say, and more than that, how you presented it.
    Too cool!

  22. I have learn several good stuff here. Definitely price bookmarking for revisiting.
    I surprise how much attempt you set to create this sort of fantastic informative website.

  23. Excellent website you have here but I was wondering if you knew of any community forums that cover
    the same topics talked about here? I’d really like to be a part
    of community where I can get opinions from other experienced people that share the same interest.
    If you have any suggestions, please let me know.
    Thank you!

  24. May I simply say what a relief to uncover an individual who actually understands what they’re talking about on the web.
    You certainly know how to bring a problem to light and make it important.
    More and more people have to read this and understand this
    side of the story. It’s surprising you’re not more popular because you surely possess the
    gift.

  25. What’s up Dear, are you truly visiting this site on a regular basis, if
    so after that you will definitely take fastidious experience.

  26. I’m gone to convey my little brother, that he should also pay
    a visit this weblog on regular basis to take updated from hottest
    news update.

  27. Why visitors still use to read news papers when in this technological world everything
    is existing on web?

  28. Really no matter if someone doesn’t understand then its up to other
    users that they will help, so here it happens.

  29. I’m curious to find out what blog platform you’re working
    with? I’m experiencing some minor security problems with my latest site and
    I would like to find something more risk-free. Do you have any solutions?

  30. hello!,I really like your writing very so much!

    percentage we communicate more approximately your article on AOL?
    I require an expert in this space to solve my problem. Maybe that’s you!

    Looking ahead to peer you.

  31. It’s hard to come by educated people for this subject, however, you seem like
    you know what you’re talking about! Thanks

  32. When some one searches for his necessary thing, therefore he/she desires
    to be available that in detail, therefore that
    thing is maintained over here.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: