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Close-up of a sonographer holding an ultrasound scanner on a patient's stomach.

Birmingham Symptom-Specific Obstetric Triage System (BSOTS)

Close-up of a sonographer holding an ultrasound scanner on a patient's stomach.

BSOTS is a maternity triage system, designed by midwives and obstetricians specifically for maternity units. It aims to standardise the triage process and ensure women are seen according to clinical need.

Introduction to BSOTS

Definitions

BSOTS

The Birmingham Symptom-specific Obstetric Triage System

Triage

The place in a maternity unit where women attend with unexpected, urgent (emergency) pregnancy or newly postnatal complications or concerns (may have an alternative name, e.g. Maternity Assessment Unit (MAU)).

Triage is also the term for the process of conducting a preliminary assessment of someone attending the triage department, to determine the urgency of their need for treatment and the nature of treatment required.

The BSOTS Bundle

BSOTS is an evidence-based package that includes:

  • A particular way of running triage, involving a brief and prompt assessment by a midwife within 15 minutes of arrival
  • Algorithms to guide any immediate and ongoing care within triage
  • Paperwork (or electronic equivalent) to support triage documentation
  • Guidance for trusts to support successful implementation of BSOTS.
A step-by-step infographic of the BSOTS Method. Explained fully in a drop-down box below the image.

BSOTS Method graphic accessible description

The BSOTS (Birmingham Symptom-Specific Obstetric Triage System) Method

  1. Brief standardised assessment completed by a midwife within 15 minutes of attendance at maternity triage
  2. Select the appropriate symptom-specific Triage Assessment Card depending on primary reason for attendance
  3. Define the level of clinical urgency using the symptom-specific algorithm
  4. Ongoing care consisting of standardised tasks and timings, to facilitate prioritisation according to clinical urgency.

Initial assessment includes:

  • Brief maternal history
  • Baseline observations
  • Assessment of pain
  • Abdominal palpation and auscultation
  • Primary reason for attendance at triage.

Triage Assessment Cards:

  • Abdominal pain
  • Antenatal bleeding
  • Hypertension
  • Postnatal concerns
  • Reduced fetal movements
  • Ruptured membranes
  • Suspected labour
  • Unwell/other.

Symptom specific algorithms and their ongoing care timings:

  • Red: immediate care
  • Orange: within 15 minutes
  • Yellow: within 1 hour
  • Green: within 4 hours.

Contact us

For any queries or support accessing the NHS Futures website, please contact bsots@contacts.bham.ac.uk.