# Patient assessment



## emergancyjunkie (Aug 29, 2011)

What's the best method to use when you do your patient assessment. So far I was told OPQRST and SAMPLE


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## phideux (Aug 29, 2011)

It all depends on the situation. You adapt your assessments to fit the situation you are in. I don't think there is a best method.


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## Handsome Robb (Aug 29, 2011)

phideux said:


> It all depends on the situation. You adapt your assessments to fit the situation you are in. I don't think there is a best method.



Quoted for truth. Don't be a cookbook medic, use the acronyms as guides not as a one-size-fits-all assessment.


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## Shishkabob (Aug 29, 2011)

You can always tell who's experienced and who's brand new by their assessment.  "Ok sir, you say your toe hurts... when did this start?  What does it feel like?  What quality is it?"

The further you get in your education, and the more experience you get, you'll understand checklist assessments are bad.


You'll eventually learn that assessments are fluid.  Watch a physician or medic do an assessment and you'll see they don't stick to "OPQRST/SAMPLE" in a strict fashion.   The questions will relate to those, but they'll be more fluid, and you'll go down a path of questioning before you come back and ask a different question.


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## Chief Complaint (Aug 29, 2011)

http://www.nremt.org/nremt/about/exam_coord_man.asp#BSkillSheets

Scroll down and you can take a look at the skills sheets.  In the field you will tailor your assessment to each situation but the skills sheets provide a guideline.


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## adamjh3 (Aug 29, 2011)

For the NREMT or real life? 

Sent from my DROIDX using Tapatalk


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## emergancyjunkie (Aug 29, 2011)

real life. I'm in pa so I have the state test to take yet. pa doenst use NREMT yet they don't even recognize EMT-I


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## Handsome Robb (Aug 29, 2011)

There's lots of things to help guide your assessments. Emphasis on the guide part of that.

AEIOU-TIPS, AVPU, SLUDGE, MONA, ABCDE, FAST, DCAP-BTLS just to name a few


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## JPINFV (Aug 29, 2011)

emergancyjunkie said:


> What's the best method to use when you do your patient assessment. So far I was told OPQRST and SAMPLE


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## Handsome Robb (Aug 29, 2011)

JPINFV said:


>



good call


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## emergancyjunkie (Aug 29, 2011)

ill have to look into that book


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## WoodyPN (Aug 29, 2011)

Like everyone has already said, better assessments come with experience. Take the acronyms/etc as guides, but don't look at every single pt. contact as the same, because it never will be.


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## medic417 (Aug 29, 2011)

emergancyjunkie said:


> What's the best method to use when you do your patient assessment. So far I was told OPQRST and SAMPLE



SAM OnScene is decent for fast reminder in field while you get the hang of things.  Found a couple on ebay.  Doesn't replace education but might be the crutch you need until you get your feet wet.

http://www.ebay.com/itm/SAM-OnScene...113?pt=LH_DefaultDomain_0&hash=item2313cce3c1

http://www.ebay.com/itm/SAM-OnScene...&otn=5&po=LVI&ps=63&clkid=2413950561465179651


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## DESERTDOC (Aug 29, 2011)

American Paramedics are laughed at by the South African Paramedics for all the acronyms we have for the most routine things.

I like the complete head-to-toe with complaint appropriate questions, amended or expanded based on mechanism or chief complaint, to include the 10 other possible things that could be going on.


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## MrBrown (Aug 29, 2011)

ZOMG SA ambos are the most hard core people on the planet, seriously man, we have some here and the stories they have are just out there.

PQRST and SAMPLE are NOT patient assessment OK? Actual patient assessment requires a thorough knowledge of basic and clinical science which even Brown only just possesses (electron what that?) 

Brown suggests reading Bates


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## Tigger (Aug 29, 2011)

I know everyone hates on the acronyms, but they did come about for a reason? One way or another I usually end up with a "SAMPLE" history on my patients. I don't ask them each letter in that order and I don't ask one question after another all at once either. The trick I think is to just let assessments flow, if your patient starts talking don't just cut her off and start asking another question, a lot of times the patient answers your questions before you ask them if you just *let them talk*.

But by the time we've gotten to the hospital, I usually have all the aspects of SAMPLE covered. I try and run through the "answers" in my head before I talk to the RN to try and not look like an idiot while fumbling for words.

More listening less talking, unless the patient doesn't provide what you need to know.


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## Chief Complaint (Aug 29, 2011)

emergancyjunkie said:


> real life. I'm in pa so I have the state test to take yet. pa doenst use NREMT yet they don't even recognize EMT-I



Even if you arent in an state that requires National Registry testing you will still have to take the state written and practicals.  The practical portion of the exam is pretty much the same as the registry skills sheets.  If you havent received them yet in class, you will soon.


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## Calichic (Sep 2, 2011)

*Airways*

Hello
I am still in EMT-B training 
I just completed the Kings/ Combi tube airway course 
Kings was no prob, I had a bit of trouble with the combi tube
Is there a special trick to it ?or a possible problem with my "pt"? 
or something that I am missing?
I was not the only one .. I don't know what was going on with the rest of class but everyone in my group had problems as well with Combi tube
Has anyone done it in real life? 
Thanks


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## mcdonl (Sep 2, 2011)

MrBrown said:


> PQRST and SAMPLE are NOT patient assessment OK? Actual patient assessment requires a thorough knowledge of basic and clinical science which even Brown only just possesses



Mr. Brown knows what he is talking about.

Every treatment you do, your radio and nursing reports and your charting will all require a good patient assesment. You need to develop a process that is comfortable to YOU, and stick with it. Just make sure it is flexible enough for every patient.

Good luck and keep asking questions.


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## MrBrown (Sep 2, 2011)

mcdonl said:


> Mr. Brown knows what he is talking about.



Gosh darn it Brown wishes people would stop saying that!! 

Does it matter if your patient with tummy pain is black, smokes and has an IUD?

What about if your patient with SOB has a fever, is scoffing down amoxicillin and is hacking up sputum?

These are examples of how a solid foundation knowledge can help your patient assessment and lead your diagnosis.


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## bigdogems (Sep 5, 2011)

SAMPLE and OPQRST are useful tools when teaching people how to do an assessment and helping to remember what questions need to be asked. But as said by others there are a ton of things that those generic questions dont answer. ie Chest Pain: Have you recently had a cough? If so have you been coughing anything up? What color is it? Is the pain worse when you take a deep breath? Is the pain worsened with palpation? Have you ever had this before? All very important questions that wouldnt be covered with a generic sample. Not to mention you will find plenty of pts that tell you they have no medical problems but then take out their full page med list


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