Checking Lymph Nodes?

DV_EMT

DV_EMT

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Just out of curiosity... how many EMT's/Medics use checking lymph nodes as a diagnostic tool while in the field? I imagine that it wouldn't be "super important", but couldn't it be good for a PCR and for nursing/doctor staff at the hospital?

(note... the reason for the start of this thread is because I'm sick and was thinking about it on my drive home from work as my lymph nodes are swollen :P)
 
I don't know about medics ( I can say I have never seen a medic check them), but the lymphatic system wasn't even mentioned in my EMT class.

As for doctors reading about it in a PCR, I'm sure the Docs aren't waiting for an EMTs report to perform a thorough physical exam.
 
When I worked as a remote (and I really mean remote) medic I did, but I also had the ability to give the pt antibiotics, so stuff like that was relevant.

The only times I do it now is if the pts neck appears swollen.
 
It certainly isn't covered in the EMT-B curriculum as something you should check. Other than noting swelling in the neck on the PCR, what would you do with that information? None of the (very limited) signs and symptoms taught to basics included swollen lymph nodes.

On the other hand, it takes a few seconds, and it's non-invasive, so if you want to do it, go ahead. Just don't do that, and then forget other things the hospital might actually want to know, like the patient's height and weight (which everybody forgets to ask a conscious patient), and medical history. :)
 
I was always taught to only do an exam or investigation if it was actually going to influence my management. I know we can all think of exceptions to this but I think it's a good general rule.

There are all sorts of bits and pieces you could do to a punter, but really, what's the point?
 
EMSLaw said:
Other than noting swelling in the neck on the PCR, what would you do with that information?
Click to expand...

To be fair, isn't that what basics do with most signs and symptoms that they're taught to look for anyways in medical patients?
 
JPINFV said:
To be fair, isn't that what basics do with most signs and symptoms that they're taught to look for anyways in medical patients?
Click to expand...

Unfortunately true.

"Swollen lymph nodes! It's the plague!"
 
EMSLaw said:
Unfortunately true.

"Swollen lymph nodes! It's the plague!"
Click to expand...

Lol.

I actually think that it might be helpful because it might be something that the hospital staff might overlook (not always, but sometimes). If you make a note on the PCR, it might clue doctors to look further into the lymphatic system.
 
Which lymph nodes are you going to check anyway? ;)

Srsly tho; would you delay transport to do this? Or is this an 'en-route' thing?
 
Last edited by a moderator:
DV_EMT said:
Lol.

I actually think that it might be helpful because it might be something that the hospital staff might overlook (not always, but sometimes). If you make a note on the PCR, it might clue doctors to look further into the lymphatic system.
Click to expand...

No offense, but do you really think that the Dr's read your PCR?:ph34r:
 
Nodes

If you note the nodes are up what then? ANd which nodes are you going to check and why? There are undoubetdly many reasons why lymph nodes may be enlarged so obviously you need to know them in the first place.

None of this sort of thing can be taken in isolation. It all requires (correct) interpretation. And to do that successfully you need an appropriate body of knowledge, training and practice under skilled supervision as well as the means to activate further investigative testing, which means you need to know which test to ask for based on a correct premise in the first place etc etc.

Docs do bucketloads of education in this area and it is combined with other subject areas like say, infective illness, immunology, haematology, microbiology, oncology, inflammatory response etc.

Infection alone is a big field - like huge. If they let us start doing such exams it will be no time before you have someone calling in the pneumonic plague.

And we haven't even gotten into the area of pre-hospital time frames and their relevenace to the way we conduct exams of pts.

Bedsides, I have a sneaking suspicion that Docs don't just write, " the nodes are up" on the pt history.

MM

A quick link below

http://www.emedicinehealth.com/swollen_lymph_glands/page2_em.htm
 
no offense but why would you? If you need to clue in an er doc to look into the lmyph system on the basis that you found them to be swollen there is a much larger problem...it is nice to know info but does not effect our treatment and or transport. We as a field need to focus on the skills that are relevant to our practice. aside from a remote setting when you are writing scripts its not important.
 
I'm not going to say that checking lymph nodes are not important, but who's to say everything we assess needs a treatment associated with it??

Why do I look for bruises in a trauma patient? I'm not going to treat those...

Why would I look for swollen ankles in a DIB patient? Not going to treat those...

The EMTP assessment curriculum doesn't really approach what we actually need to assess to have a good clinical picture of a patient. Sure, it's enough to be a cookbook medic and follow some protocols. "Hey, he says he's having difficulty breathing, and he's wheezing, so let me check my book, and er, oh, here it says we should give some albuterol." Does that adequately treat the patient? Maybe they're in CHF and your albuterol worsens their condition... Did you take a thorough distant and recent history? Check the ankles? Really listen to lung sounds in 6+ fields?

Anyway, another thread where the "but it's 5 minutes to the ER" and "I don't need to know that" mentality will probably prevail.
 
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