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

H

Handsome Robb

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VentMonkey said:
"Why on earth would they call you Handsome Robb?!!"- Mr./Mrs. Smith:p
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Pffffft!!!! Old ladies love me.


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Akulahawk

Akulahawk

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Like most, I pretty much lead off with something like "What's bothering you?" After that, I tend to, as other have said, go into more pointed questions about the patient's symptoms. Sure, OPQRST/SAMPLE does work but those are basically just a way to get the new person to cover the basics. In a way, when I'm asking patients about their problems, it may appear more like a directed conversation. Within a few minutes I'll pretty much cover all the basics while honing in on the underlying problem as much as I can. As I finish the focused exam, then I'll ask some more general questions about other body systems, more to exclude them as an issue, and then I'll finish with "Is there anything else bothering you" because often that elicits more info about the general health of the patient and their other health concerns that they may not otherwise have thought to address initially.

Another way to put it is that we all started learning how to do this using a script but with experience, we pretty much all lose the script and start with open-ended questions and focus in from there.
 
medichopeful

medichopeful

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"Hello! I'm medichopeful, I'm one of the ER nurses here. So what's going on today?"

If I'm working in the ICU, and the patient is able to respond or there's family there, it's generally something along the line of "Hello, I'm medichopeful and I'm gonna be your nurse for the rest of the night. How are you feeling?"

From there, the conversation goes where it needs to go. For example, I'm not going to ask a patient who stubbed their toe the last time they ate something, because it's almost certainly not relevant. On the other hand, I will ask the patient who is nauseous when the last time they kept something down was. Complaints dictate what questions I ask.
 
Akulahawk

Akulahawk

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medichopeful said:
"Hello! I'm medichopeful, I'm one of the ER nurses here. So what's going on today?"

If I'm working in the ICU, and the patient is able to respond or there's family there, it's generally something along the line of "Hello, I'm medichopeful and I'm gonna be your nurse for the rest of the night. How are you feeling?"

From there, the conversation goes where it needs to go. For example, I'm not going to ask a patient who stubbed their toe the last time they ate something, because it's almost certainly not relevant. On the other hand, I will ask the patient who is nauseous when the last time they kept something down was. Complaints dictate what questions I ask.
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Pretty much how I do things now... minus the ICU part. Especially with elderly patients, I'll hang out for a bit and chat with the patient and/or family just to find out if the patient's confabulating things just to cover some early dementia. When family is around, it's helpful simply because they can let me know if the patient is mentating at their normal baseline while also allowing me the chance to observe the intra-family dynamics. Sometimes that can be enlightening.
 
SpecialK

SpecialK

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I be sure to ask them how they are going to pay for my services; I am highly qualified and experienced do not come cheap.

Naw I usually ask them what's wrong unless it's very clinically obvious.
 
akflightmedic

akflightmedic

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"Can you hold a pen and can you sign here...?" as I extract one of the refusal forms.
 
CALEMT

CALEMT

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VentMonkey said:
How you (I) know there's a "changing of the guards". I wonder how many newer (see younger) EMS providers will get this reference.
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Those of us who will start a paper PCR for the medic. Plus the fire dept still uses paper PCR's.
 
VentMonkey

VentMonkey

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CALEMT said:
Those of us who will start a paper PCR for the medic. Plus the fire dept still uses paper PCR's.
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I was just talking to one of our managers about ePCR's yesterday and how by next year everyone needs to he NEMSIS compliant, so paper PCR's are, or will be obsolete.

I miss the paper charting at times, and @DEmedic's post just made me chuckle a tad.

Glad to know some people help their paramedics chart though;).
 
CALEMT

CALEMT

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VentMonkey said:
I was just talking to one of our managers about ePCR's yesterday and how by next year everyone needs to he NEMSIS compliant, so paper PCR's are, or will be obsolete.

I miss the paper charting at times, and @DEmedic's post just made me chuckle a tad.

Glad to know some people help their paramedics chart though;).
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We're integrating image trend in our county. Its kinda weird being able to open a PCR on my home wifi on my personal laptop and cell phone.
 
VentMonkey

VentMonkey

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Again, aside from my above mentioned treatments, there's no harm in PO ASA, for me, after I have given the Zofran IVP since he's already had N/V; it's the humane thing to do.

You could try a judicious 250 ml fluid challenge, but I'd be hard pressed to go anymore than that.

Op, do you care to share your reasoning for Atropine?...aside from "ACLS guidelines" dictating such therapies?
 
CALEMT

CALEMT

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Looks like someone posted in the wrong thread :)
 
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