Fatigue and weakness triage

Red flags

• Progressive weakness with neurologic deficits or cardiorespiratory instability.
• Unintentional significant weight loss, persistent fevers, or bleeding symptoms.
• Inability to maintain activities of daily living safely.

Assessment priorities

• Clarify onset timeline, systemic symptoms, and functional impact.
• Review sleep quality, mood, medication effects, and chronic disease context.
• Identify patterns suggestive of endocrine, hematologic, infectious, or cardiopulmonary causes.

Initial management

• Use targeted first-line workup based on clinical pattern and risk profile.
• Start supportive plan addressing hydration, activity pacing, and sleep hygiene.
• Ask about delayed post-exertional worsening. When ME/CFS is suspected, avoid fixed increases in exercise or advice to push through symptoms; use individualized energy management while investigating other causes.
• Document explicit thresholds for reassessment and escalation.

Follow-up and escalation

• Review symptom trend and investigation results in short interval.
• Escalate when red flags emerge or trajectory worsens.
• Coordinate specialist pathway for persistent unexplained fatigue.

References

• HealthLink BC Weakness and fatigue (opens in a new tab)
• NICE NG206 Suspected ME/CFS assessment and energy management (opens in a new tab)

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