What are your initial questions that you ask when you first interact with a patient?

Loshi

Loshi

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Do any of you have a script? or do you just go through the general SAMPLE and OPQRST questions?
 
Hi Sir/Ma'am/Miss, what's your name?
It's nice to meet you Mrs. Jones, I'm Gurby and this is my partner JimBob.
So what happened today? / the firefighters were saying you're having some chest pain today? / etc

From there it's basically freestyle trying to figure out what is going on. If you pay attention when skilled clinicians interview patients, you will find that they tend to ask pointed and specific questions rather than follow a generic script like OPQRST. You basically start with an undifferentiated patient, and as you discover new information (is it chest "pressure" vs "stabbing" vs "burning" etc) you begin to narrow down the possibilities of what it could be. The questions you ask will change depending on which differential diagnoses you're considering.

...and then when you think you're done, ask them, "is anything else bothering you?" because there is almost always something else, and then you look like an idiot when the ED doc does their assessment and it turns out you missed something.
 
Gurby said:
Hi Sir/Ma'am/Miss, what's your name?
It's nice to meet you Mrs. Jones, I'm Gurby and this is my partner JimBob.
So what happened today? / the firefighters were saying you're having some chest pain today? / etc

From there it's basically freestyle trying to figure out what is going on. If you pay attention when skilled clinicians interview patients, you will find that they tend to ask pointed and specific questions rather than follow a generic script like OPQRST. You basically start with an undifferentiated patient, and as you discover new information (is it chest "pressure" vs "stabbing" vs "burning" etc) you begin to narrow down the possibilities of what it could be. The questions you ask will change depending on which differential diagnoses you're considering.

...and then when you think you're done, ask them, "is anything else bothering you?" because there is almost always something else, and then you look like an idiot when the ED doc does their assessment and it turns out you missed something.
Click to expand...
Yeah...what I said?!:).

But in all seriousness, op, this is a perfect breakdown. There's no real "scribing" most of the time. I may ask the big burly fire captain to jot stuff down on dynamic calls, and/ or grab their cards, and meds and put em in a ziplock.

Again, what @Gurby said is the jist in a nutshell. Oh, and the longer you do it, the more out of order it seems, but you will know what is and is not pertinent to a specific complaint, and how to stop the patient from rabbit trailing.

The only other thing I emphasized to the newer folk was "talk-n-walk", aka, multitasking.
 
DEmedic said:
"Hi, what's goin' on?"
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Are you detecting a theme yet, op?

This question is your ice breaker and will yield your chief complaint, you build from there.

If at first you need to write stuff down to help you remember, by all means, knock yourself out. Just try not to get into a habit of making everything a systematic approach.

No two patients are the same, and you can't fit a square peg into a round hole.
 
sup_dog.jpg
 
For a serious answer: it varies. If I get called to a stabbing or GSW my first question is usually "where are you shot/stabbed at?"

If I walk into a house and see someone who is in severe respiratory distress I'm not going to ask "what's going on?" As it is already known.

I forget to mention my name on initial patient contacts probably 90% of the time. When I remember we are usually loading the patient into the ambulance or are already transporting.
 
"Hi, whats your name?"....unless they are OD'd on heroin or some **** and cant give a name. Then I just roll from there depending on what's going on.
 
"Hi Mr./Mrs. Smith my name is Handsome Robb, I'm one of the Paramedics on the ambulance. What's going on today?"


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Handsome Robb said:
"Hi Mr./Mrs. Smith my name is Handsome Robb, I'm one of the Paramedics on the ambulance. What's going on today?"


Sent from my iPhone using Tapatalk
Click to expand...
"Why on earth would they call you Handsome Robb?!!"- Mr./Mrs. Smith:p
 
Cash or insurance?
 
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