Hx

[daedalus]

...."okay so tell me about your medical history, past issues, surgeries, or problems..."
"None im perfectly healthy except for this leg injury"

"Oh okay, sounds good. What about medications you take?"

"I take lasix and some painkiller"

"whats the lasixs for""

"I had some swelling or something because of my heart i see the cardiologist now"

"and the pain killer?"

"its for my rheumatoid arthritis, and because of a surgery to fix a bowel obstruction"

"oh okay, so your medical history of ABD surgery and heart failure?"

"no healthy as can be"

happens 1/3 patients.
and this is no exaggeration

 

[skyemt]

usually, it is because you are asking in a way that the patient is misunderstanding... clear communication, not clear to you but clear to the patient, is most important.

many patients, who have had a previous MI, but are now stable, have stents, see a dr regularly, and have not had another MI feel like they don't have "the problem" or issue anymore... we may feel that is incredulous, but they do feel that way.

if you ask about an issue or HX, they may not feel it is what you are looking for... the classic "i don't have that problem anymore" mentality.

if you ask if they have EVER had any heart troubles, believe me, they will tell you.

usually if you do not get the answer you are looking for, the problem is with the questions, or the way you are asking them, rather than with the patient.

 

[Ops Paramedic]

I agree with Skyemt has posted. Your first question is already way to long and you have forced the patient into thinking which section of the question to answer, chosing one, and then forgetting completly about the others. Remeber that the patient called you out because this is his emergency, and may not be in his normal state of mind. So that info is lost to you. The question should rather have been: 'Do you have any medical problems (...that you are/where treated for)??

As mentioned, these patients live with there conditions, and for them it is absolutely normal, as they have adopted it as part of their lifestyle. It is of vital importance to communicate properly with patients. (There are threads already explaing the same). Once again: Presentation (of both), body language, setting, how the question are asked and answered, tone of voice, articulation of speech, grammer, etc., etc., etc.,.... You will be surprised what you can get out of a patient when done properly!!

Your second section of questioning was good, as you followed a lead, which provided you with what you wanted to know in the first place. It is not the patient's fault that we do not get the info we require...

 

[paramedix]

"Why have you called the ambulance today?" "What have changed today"
Patients can sometimes get distracted to the point at hand and do not always understand why you need to know everything. They just want to be treated for the condition they called you.

Skyemt said, the patients see their condition as stable and they see the dr regularly, so they might be confused by your question or even reluctant to answer.

Ops Paramedic mentioned that patients gets so used to a condition that they might not even realize its abnormal.

Thus again, what changed now and what made it change now...?