Opqrst & Why

[skyemt]

Find the smart people; the ones who are well respected in their field: medics, nurses, doctors. And pick their brains for years.

my experiences so far, which admittedly are limited because i am relatively new to EMS, are that there is a HUGE gulf between providers, even ALS, when it comes to getting a good history... ranging from almost "scoop and run, let the hospital figure it out", to our best, who in a short time can gain a tremendous amount of pertinent information.

when one realizes the scope of skill involved in getting a truly good history, it becomes somewhat daunting... realizing that it will take years of practice and experience, and studies, to one day become skilled at it. i am willing to put the work in, so we'll see what comes out in a few years...

i know some will say it just isn't that important, but to me it is.

thanks to all for their input and advice.

 

[joemt]

I just start having a conversation with most of my "medical" patients.... before long, all of those "alphabet soup" questions are answered... plus, I usually find something out about the patient that my mneumonic questioning wouldn't have gotten me.

Just my .02

 

[skyemt]

I just start having a conversation with most of my "medical" patients.... before long, all of those "alphabet soup" questions are answered... plus, I usually find something out about the patient that my mneumonic questioning wouldn't have gotten me.

Just my .02

really? i just start talking to the patient and all the important information not covered by OPQRST just comes right out... wow...

well, now it's not quite as simple as that, is it? the point of this post was to get information in a way not covered by the "alphabet soup" questions...

if someone has a way, please by all means, what techniques are you using... what questions are you asking...

sorry, but "just start talking to the patient" is not at all what this thread was about.

 

[joemt]

Ok, wow... do I feel like I've been whipped.

So, things may not always be as easy as that, but more times than not, I get all of my information (and then some), by just starting up a conversation. Sometimes I feel like we get so bogged down by trying to remember the "NREMT" sequence of things that we forget that there may be other information that can be just as important. I guess my point was to never forget that the patient is a person, and that we should do our best to talk "to" them, not "at" them. You catch more flies with honey than with vinegar....
The questions vary from patient to patient, but many times, just having someone show that they care, will lead to comments, or important themes that may be an underlying or contributing issue. Why is this not enough of an answer for the thread?

 

[skyemt]

Ok, wow... do I feel like I've been whipped.

So, things may not always be as easy as that, but more times than not, I get all of my information (and then some), by just starting up a conversation. Sometimes I feel like we get so bogged down by trying to remember the "NREMT" sequence of things that we forget that there may be other information that can be just as important. I guess my point was to never forget that the patient is a person, and that we should do our best to talk "to" them, not "at" them. You catch more flies with honey than with vinegar....
The questions vary from patient to patient, but many times, just having someone show that they care, will lead to comments, or important themes that may be an underlying or contributing issue. Why is this not enough of an answer for the thread?

once again... nothing personal... off topic.

this thread is about specifics...
how bad do you think we are that we don't know to let a patient know we care? or to talk to them as a person?

it doesn't get more basic than that...

seriously, i'm sure you are a very good emt..
this thread is about SPECIFIC techniques and questions.
thank you.

 

[joemt]

I was making a general statement... I apologize for getting the post off topic (although I don't feel the answer is off topic). No offense taken, I was simply just making a statement that I feel that my comments were right on topic. I have no doubt that the larger percentage of people who come into the forums, and participate are very caring and compassionate folks, I was just posting a reminder.

I hereby give up on trying to make my point, and will step away from your topic.

 

[bonedog]

To establish good communication I will usually offer my hand and introduce myself. IF the pt takes my hand I cover it with my other, which is taking a radial pulse, however, the patient usually interprets this as I am a truly caring individual. This establishes an excellent rapport from the get go and shows you are there to care for THEM.( this gives you instant buy in and their undivided attention)

As for questions, I always ask if they have any pain or dyscomfort, as often people will discount pressure/squeezing/burning as not being pain.

For SOB pt's the intubation question is a must, also if they are on steroids, where are they in their cycle, are they tapering down. What is their trigger, and have they been exposed.

IF they are in extremis( answers in one or two words), I explain to them I want a thumbs up for a yes and no response for a no answer. This allows them to concentrate on their resp's with out talking.

In these case's I tell my students they have to ask the high yeild questions and may limit them to 3 question only. These questions depend on the potential differential you suspect.

 

[JPINFV]

I think that this is one of those things where a good pathophys course would be helpful. You don't know what to ask to rule in or out anything if you don't know that the disease or condition exists.