A&O status questions

[oneangryfilm]

Hello all! Some of my coworkers were discussing what questions are appropriate to ask to determine if a pt is alert and oriented. Everyone has their preference and try steering away from certain questions, such as "who's the president?" Does anyone have any specific questions they ask? Thanks!

 

[Chris07]

1. What's your name?
2. Where are you right now?
3. What day of the week is it? (Or ask for the year, sometimes people forget the day of the week like urban outdoorsmen and snf pts.)
4. What happened? (If injury) What were you doing before you called 911? Something to that regard. The point is to establish if the person is oriented to a recent event in the past.

 

[mycrofft]

I keep talking to the pt and eliciting answers. I'm listening for slurring, recent memory, changes as we are talking, changes in history or medication or allergic status, promptness of answers, and if the pt has questions, to see if they keep re-asking the same questions, sort of like EMTLIFE.
PS: don't use speech ("complete sentences") as a basis to treat for asthma.

 

[Anjel]

A lot of people I work with use

"How many quarters in a dollar"

I guess that's alright. Idk though.

I use name, place, year, and president, or what we are doing.

 

[lightsandsirens5]

Don't ask questions if you don't know the answer.

 

[NomadicMedic]

Is Mickey Mouse a cat or a dog?

If they're with it, they look at you funny and answer correctly.

If they're altered, they answer "a cat... No... A dog. Wait. What?"

 

[JPINFV]

Don't ask questions if you don't know the answer.

Yea... it's always bad when asking what day of the week it is and you have to look at your watch to confirm the day.


If you also want to get fancy, you can always start pulling from the Mini Mental Exam (a misnomer if there ever was one). Things like serial 7s (start at 100, count backwards by 7), remember 3 words (ask at 1 minute and 5 minutes), spell "world" forwards and backwards can add to your assessment.

 

[TRSpeed]

Yea... it's always bad when asking what day of the week it is and you have to look at your watch to confirm the day.

This. I am guilty of it lol

 

[Achilles]

The skies over (city name goes here) blue.
See if they can say it, see if they can repeat it in five minutes.
A&O:
1: Person
2: Place
3. Time
4. Event

 

[leoemt]

Person, place, time and event is what I ask and seems to be the standard in the medical community. Regardless what you ask you need to keep it consistent so you can remember their response.

Were they alert to person and time only? In EMT class, some of the students would ask "who is the president" or "whats my name". I believe in KISS principle and the easier questions to answer the more accurate of a representation it will be.

 

[Aprz]

I generally don't ask them the questions straight up other than their name as I introduce myself. I'll ask 'em questions or talk about things that pertain to person, place, time, and event (or purpose e.g. "What brought you to this Safeway (grocery store) today?", which you'd expect the answer to be similar to "buy groceries"), but it's not as straight forward as asking "What's your name? Where are you? What day of the week (or what month is it)? What happened?" like I would ask in class, and I'll ask multiple question (not just one per criteria) to confirm whether they are oriented. I'll look for their reaction and carefully listen to their response. I like to believe that if they aren't oriented, it's easy to tell just by taking with them. You can pickup on their facial reaction, what they are doing, how they answering things, and the disconnect between me and them.

 

[VFlutter]

I dont ask who is the president after getting a few not so polite responses such as "that :censored::censored::censored: Obama"

 

[Aidey]

One of my favorite responses to that question:

Me - Who is the president?
Pt - That rat b@stard!
Me Which one, half the country thinks the current one is a rat b@stard and the other half thinks the last one is a rat b@stard.
Pt - Nixon of course! (While giving me a look like I was a complete idiot.)

 

[Refino827]

I usually ask:

What is your name?
Do you know where you are?
Who is the president OR how many quarters are in a dollar?
What happened leading to events?

 

[Brandon O]

I generally don't ask them the questions straight up other than their name as I introduce myself. I'll ask 'em questions or talk about things that pertain to person, place, time, and event (or purpose e.g. "What brought you to this Safeway (grocery store) today?", which you'd expect the answer to be similar to "buy groceries"), but it's not as straight forward as asking "What's your name? Where are you? What day of the week (or what month is it)? What happened?" like I would ask in class, and I'll ask multiple question (not just one per criteria) to confirm whether they are oriented. I'll look for their reaction and carefully listen to their response. I like to believe that if they aren't oriented, it's easy to tell just by taking with them. You can pickup on their facial reaction, what they are doing, how they answering things, and the disconnect between me and them.

Same. Likewise for the "speech" portion of the Cincinnatti Stroke Scale. The only time I go for more direct questions is for, perhaps, the very critical and altered patient where there isn't much time to chit-chat. And even there the window for usefulness is sort of limited.

 

[DesertMedic66]

What's your name?
Where are you at?
What day or time of the day is it?
What happened?

I come from an area that contains under educated people so I don't ask what recent holiday passed or who the president is or how much money is in my pocket.

However I don't always ask these questions. I start by having normal conversations and ill slip in one or two of those questions. If I think they are altered then I will ask all 4.

 

[Epi-do]

One of my favorite responses to that question:

Me - Who is the president?
Pt - That rat b@stard!
Me Which one, half the country thinks the current one is a rat b@stard and the other half thinks the last one is a rat b@stard.
Pt - Nixon of course! (While giving me a look like I was a complete idiot.)

I think the best response I have ever gotten to that question was "John :censored::censored::censored::censored:in' Fogerty, man!"