Need help with Pt Assessment follow up questions

[Sean Mathews]

Hello all,

Pretty new to posting on the forums but have read quite a bit on here. I work as a Firefighter/EMT in California and on calls my crew is having me practice my assessments, which i am loving because i need the practice. One thing i ALWAYS find myself messing up on are the follow up questions to the pt. Now my partners are Firefighter Paramedics so i know their knowledge depth is much greater. But for calls like syncope, chest pain, difficulty breathing, abdominal pain, etc. (basically any call). While talking to the PT i can never think of the right follow up questions to their symptoms.

Does anyone on here have a good resource or recommendation to learn about the follow up questions for certain chief complaints?

Any help is appreciated,

Thank you,
Sean

 

[Jim37F]

Quite frankly what was the single best resource for me was paying attention to the follow up questions the nurses at the hospital asked me (or when I couldn't answer, what they, or the odd doctor floating around doing triage at one of my hospitals asked the patient directly) when I arrived and gave them my report. You'll hear the same questions for the same complaints. Enough times of getting a question that I would have to immediately turn around and ask the patient, get the patients answer, turn around and tell the nurse, and you'll learn to start anticipating thise questions (as well as what info they don't care about, like in my area no one seemed to care that much about last oral intake unless it was directly pertinent lol)

 

[StCEMT]

I quit following templates a long time ago and just ask specific questions geared towards the complaint. One thing that will help early on is to see what questions are asked by RN/MD when at the hospital. That gives you an idea of what they will look for in the turnover report.

So ex. 70~ y/o falls. Trip or medical cause? Surface or object hit? Height of fall? LOC? Blood thinners? Injuries? Dizzy, nausea, etc post fall? Pupils? Vitals?

A lot of those questions are not going to pop up in my initial questions with a respiratory call. Target your questions to the problem.

 

[mgr22]

Sean, a follow-up question is supposed to be based on the answer to the previous question. It's less about templates and more about dialogue. Conversations with friends, for example, are heavily driven by what was last said.

Don't overthink, in advance, what you're supposed to ask. Instead, try to get to the point where you're listening to the answer to the question you just asked, and basing your next question on that. It might also help to think of what you, as just another person, are curious about knowing next. For example, if I told you I hurt, you'd probably ask me where. I don't think you'd suddenly be curious about my last meal.

This won't happen overnight, but the more experience you get, the more you'll decide what to ask next without even thinking about it.

 

[NomadicMedic]

Being an active listener is how you determine and ask the best follow up questions.

For example, on a syncope call, you ask the patient what meds they take, they answer “lisinopril”.

Now you know that’s a Med commonly scripted for HTN. But, you want to know more about it.

Is that a new Med? How long have you been taking it? Have you been taking it as prescribed? Did you eat and drink as normal today? Been sick recently?

I mean, you’re asking questions that relate to the injury or illness, but you want to do it in a conversational way. Ask a question, get a answer, ask a clarifying question.

Are you allergic to anything?
Yeah, penicillin.
What happens when if you take penicillin?
I have a hard time breathing.
Oh, do you have an Epi Pen?
Yeah. My doc said I should keep one with me all the time.

That’s good information, right? Now you know that the patient has had a confirmed allergic reaction to cillins and carries an Epi Pen. You got that info from a quick conversation.

 

[Lo2w]

Take any drugs or alcohol today?
Yes, I smoked/shot/snorted ___
Get it from your regular guy?

Normal day for us

 

[DesertMedic66]

Take any drugs or alcohol today?
Yes, I smoked/shot/snorted ___
Get it from your regular guy?

Normal day for us

I’ve had to ask this question way to much.

 

[CALEMT]

I’ve had to ask this question way to much.

Except you ask whats his number and how much does he have left.