the patient’s fear and promote cooperation. Wheneverpossible, conduct the subjective interview while youare performing the physical examination.Relatives and bystanders at the emergency scenemay also serve as sources of information, but youshould not interrupt interviewing the patient to gatherinformation from a bystander. If the patient isunconscious, you may obtain information frombystanders and medical identification devices whileyou are conducting the physical examination.When conducting a patient interview, you shouldtake the following steps:1. Place yourself close to the patient. Positionyourself, when practical, so the patient can seeyour face. If at all possible, position yourself sothat the sun or bright lights are not at your back.The glare makes it difficult for the patient tolook at you.2. Identify yourself and reassure the patient.Identify yourself and maintain a calm,professional manner. Speak to the patient inyour normal voice.3. Learn your patient’s name. Once you learnthe patient’s name, you should use it during therest of your interview. Children will expect youto use their first name. For military adults, usethe appropriate rank. If civilian, use “Mr.” or“Ms.” unless they introduce themselves by theirfirst name.4. Learn your patient’s age.Age informationwill be needed for reports and communicationswith the medical facility. You should askadolescents their age to be certain that you aredealing with a minor. With minors, always askhow you can contact their parent or guardian.Sometimes this question upsets childrenbecause it intensifies their fear of being sick orinjured. Be prepared to offer comfort and assurechildren that someone will contact their parentsor guardians.5. Seek out what is wrong. During this part of theinterview, you are seeking information about thepatient’s symptoms and what the patient feels orsenses (such as pain or nausea). Also, find out whatthe patient’s chief complaint is. Patients may giveyou several complaints, so ask what is botheringthem most. Unless there is a spinal injury that hasinterrupted nerve pathways, most injuredindividuals will be able to tell you of painful areas.6. Ask the PQRST questions if the patient isexperiencing 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., “intomy shoulder”)?R=RecurrenceHas this happened before?R=ReliefDoes anything make it feel better?S=SeverityHow bad is it on a scale of 1 to10?T =TimeWhen did it begin?7. Obtain the patient’s history by asking theAMPLE questions.A=Allergies¾Are you allergic to anymedication or anything else?M=MedicationsAre you currently takingany medication?P=Previous medical history¾Have you beenhaving any medical problems? Have you beenfeeling ill? Have you been seen by a physicianrecently?L=Last meal¾When did you eat or drink last?(Keep in mind, food could cause the symptomsor aggravate a medical problem. Also, if thepatient requires surgery, the hospital staff willneed to know when the patient has eaten last.)E=Events¾What events led to today’sproblem (e.g., the patient passed out and thengot into a car crash)?Objective ExaminationThe objective examination is a comprehensive,hands-on survey of the patient’s body. During thisexamination, check the patient’s vital signs andobserve the signs and symptoms of injuries or theeffects of illness.When you begin your examination of the patient,you should heed the following rules:1. Obtain the patient’s consent (if the patient isalert).2. Tell the patient what you are going to do.4-5
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