the patients fear and promote cooperation. Whenever
possible, conduct the subjective interview while you
are performing the physical examination.
Relatives and bystanders at the emergency scene
may also serve as sources of information, but you
should not interrupt interviewing the patient to gather
information from a bystander.
If the patient is
unconscious, you may obtain information from
bystanders and medical identification devices while
you are conducting the physical examination.
When conducting a patient interview, you should
take the following steps:
1. Place yourself close to the patient. Position
yourself, when practical, so the patient can see
your face. If at all possible, position yourself so
that the sun or bright lights are not at your back.
The glare makes it difficult for the patient to
look at you.
2. Identify yourself and reassure the patient.
Identify yourself and maintain a calm,
professional manner. Speak to the patient in
your normal voice.
3. Learn your patients name. Once you learn
the patients name, you should use it during the
rest of your interview. Children will expect you
to use their first name. For military adults, use
the appropriate rank. If civilian, use Mr. or
Ms. unless they introduce themselves by their
4. Learn your patients age.
will be needed for reports and communications
with the medical facility.
You should ask
adolescents their age to be certain that you are
dealing with a minor. With minors, always ask
how you can contact their parent or guardian.
Sometimes this question upsets children
because it intensifies their fear of being sick or
injured. Be prepared to offer comfort and assure
children that someone will contact their parents
5. Seek out what is wrong. During this part of the
interview, you are seeking information about the
patients symptoms and what the patient feels or
senses (such as pain or nausea). Also, find out what
the patients chief complaint is. Patients may give
you several complaints, so ask what is bothering
them most. Unless there is a spinal injury that has
interrupted nerve pathways, most injured
individuals will be able to tell you of painful areas.
6. Ask the PQRST questions if the patient is
experiencing pain or breathing difficulties.
P=Provocation¾What brought this on?
Q=Quality¾What does it feel like?
R=Region¾Where is it located?
R=ReferralDoes it go anywhere (e.g., into
R=RecurrenceHas this happened before?
R=ReliefDoes anything make it feel better?
S=SeverityHow bad is it on a scale of 1 to
T =TimeWhen did it begin?
7. Obtain the patients history by asking the
A=Allergies¾Are you allergic to any
medication or anything else?
M=MedicationsAre you currently taking
P=Previous medical history¾Have you been
having any medical problems? Have you been
feeling ill? Have you been seen by a physician
L=Last meal¾When did you eat or drink last?
(Keep in mind, food could cause the symptoms
or aggravate a medical problem. Also, if the
patient requires surgery, the hospital staff will
need to know when the patient has eaten last.)
E=Events¾What events led to todays
problem (e.g., the patient passed out and then
got into a car crash)?
The objective examination is a comprehensive,
hands-on survey of the patients body. During this
examination, check the patients vital signs and
observe the signs and symptoms of injuries or the
effects of illness.
When you begin your examination of the patient,
you should heed the following rules:
1. Obtain the patients consent (if the patient is
2. Tell the patient what you are going to do.