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Medical history
Symptoms or Signs

What should you elaborate about a symptom or sign?

Is it a medical emergency?
Do you know what are emergency medical symptoms, signs, or complaints?
What are emergency medical symptoms, signs or complaints?
Does this need on-the-spot diagnosis and treatment?
When did it start?
How did it start?
Where did it start?
What is the most likely diagnosis?
What do you think causes it?
Why do you think this happened?

Harms Evaluation/Medico-legal

When did it happen?
How did it happen?
Where did it happen?
Who all are involved?
What are their profiles?
Which, whose profile is required?
Why did they do this?
What should be done?

Emergency

What questions should you ask in case of a medical emergency?
What questions should you ask the patient?
What questions should you ask person with or reporting for the patient?

Emergency

Are you the person reporting a medical emergency for yourself?

Do you have any existing medical condition?
Did you have any previous medical condition that does not exist now?
Do you take any medications now?
Did you take any medications in the past that you are not taking now?
Do you think any health care details need to be added?
Are you the person reporting a medical emergency of another person?
What do you have to do while reporting a medical emergency of another person?
What details should be ready?
How are you related to the person?
How do you know him or her?

If there is any violence in the community, take it seriously. Do extensive research and investigation on the cause of this violence and the people involved. No questions can remain unanswered.
How do you do a quick assessment, diagnosis, and treatment of a conscious patient?
The new problem is not a medical emergency. Follow-up medical consultation. Problem that is a medical emergency (In case of a medical emergency, your local emergency service is the first responder. Guidelines for your local emergency responder are at this location: http:www.qureshiuniversity.com/emergencyworld.html). Annual health assessment.
Patient been referred by you to others.
Patient been referred to you by others.
Human health symptoms & signs A-Z List.
Human health emergency symptoms & signs A-Z List.
What should you enclose with the referral of the patient?
New Patient Consultation
How do you do a quick assessment, diagnosis, and treatment of an unconscious patient?

If the patient is unconscious, these questions need to be answered.

How long has he/she been unconscious?
What do you think is the likely cause of the problem?
Does he/she have any existing medical condition?
Did he/she have any previous medical condition that does not exist now?
Does he/she take any medications now?
Did he/she take any medications in the past that he/she is not taking now?
What are the reasons patients are not satisfied with services of medical doctors?
How do you do a quick assessment, diagnosis, and treatment of pediatric cases under the age of 28 days, six months, one year, and five years?
How do you do a quick assessment, diagnosis, and treatment of a person who is deaf and mute?
How do you do a quick assessment, diagnosis, and treatment of a person under anesthesia, sedation, or asleep?
The reference resource for medical doctors.
The reference resource for human health care.
History of the present illness

When or approximately when did it start?

Did it begin gradually or suddenly?
- If gradually, over what period of time? How long did it take to develop?

Did anything cause or contribute to the onset?

Have you ever had anything like this before?
- If yes, did it feel the same? What was the outcome?

Can you point to the exact location of your symptoms?
- Describe

Does it travel (radiate) to any other part of your body?
- Describe

Do you have symptoms in any other part of your body?

Can you describe the sensation? (dull, sharp, burning, aching, gnawing, throbbing, shooting, constricting, other)

How would you describe the intensity? (mild, moderate, severe, other; 1-10 scale)

Has it been constant or does it come & go? (Constant, intermittent, episodic)

Has it been getting better, worse, or staying the same?

Have you found anything that makes it better? (rest, morning, evening, certain position, other)

Have you found anything that makes it worse? (positions, activities, morning, evening, coughing, sneezing, straining, other)

Has there been a change in any bodily functions? (urination, defecation, respiration, digestion, vision, sexual, other)

Has it affected your daily activities in any way?

Have you tried store bought or home remedies?
- If yes, what was the effectiveness?

Have you sought other professional care for this condition?

Is there anything else you would like to discuss or that would be important for me to know?

Getting Started:
Always introduce yourself to the patient. Then try to make the environment as private and free of distractions as possible. This may be difficult depending on where the interview is taking place. The emergency room or a non-private patient room are notoriously difficult spots. Do the best that you can and feel free to be creative. If the room is crowded, it's OK to try and find alternate sites for the interview. It's also acceptable to politely ask visitors to leave so that you can have some privacy.

If possible, sit down next to the patient while conducting the interview. Remove any physical barriers that stand between yourself and the interviewee (e.g. put down the side rail so that your view of one another is unimpeded... though make sure to put it back up at the conclusion of the interview). These simple maneuvers help to put you and the patient on equal footing. Furthermore, they enhance the notion that you are completely focused on them. You can either disarm or build walls through the speech, posture and body languarge that you adopt. Recognize the power of these cues and the impact that they can have on the interview. While there is no way of creating instant intimacy and rapport, paying attention to what may seem like rather small details as well as always showing kindness and respect can go a long way towards creating an environment that will facilitate the exchange of useful information.

If the interview is being conducted in an outpatient setting, it is probably better to allow the patient to wear their own clothing while you chat with them. At the conclusion of your discussion, provide them with a gown and leave the room while they undress in preparation for the physical exam.

Initial Question(s):
Ideally, you would like to hear the patient describe the problem in their own words. Open ended questions are a good way to get the ball rolling. These include: "What brings your here? How can I help you? What seems to be the problem?" Push them to be as descriptive as possible. While it's simplest to focus on a single, dominant problem, patients occasionally identify more then one issue that they wish to address. When this occurs, explore each one individually using the strategy described below.

Follow-up Questions:
There is no single best way to question a patient. Successful interviewing requires that you avoid medical terminology and make use of a descriptive language that is familiar to them. There are several broad questions which are applicable to any complaint. These include:

  1. Duration: How long has this condition lasted? Is it similar to a past problem? If so, what was done at that time?
  2. Severity/Character: How bothersome is this problem? Does it interfere with your daily activities? Does it keep you up at night? Try to have them objectively rate the problem. If they are describing pain, ask them to rate it from 1 to 10 with 10 being the worse pain of their life, though first find out what that was so you know what they are using for comparison (e.g. childbirth, a broken limb, etc.). Furthermore, ask them to describe the symptom in terms with which they are already familiar. When describing pain, ask if it's like anything else that they've felt in the past. Knife-like? A sensation of pressure? A toothache? If it affects their activity level, determine to what degree this occurs. For example, if they complain of shortness of breath with walking, how many blocks can they walk? How does this compare with 6 months ago?
  3. Location/Radiation: Is the symptom (e.g. pain) located in a specific place? Has this changed over time? If the symptom is not focal, does it radiate to a specific area of the body?
  4. Have they tried any therapeutic maneuvers?: If so, what's made it better (or worse)?
  5. Pace of illness: Is the problem getting better, worse, or staying the same? If it is changing, what has been the rate of change?
  6. Are there any associated symptoms? Often times the patient notices other things that have popped up around the same time as the dominant problem. These tend to be related.
  7. What do they think the problem is and/or what are they worried it might be?
  8. Why today?: This is particularly relevant when a patient chooses to make mention of symptoms/complaints that appear to be long standing. Is there something new/different today as opposed to every other day when this problem has been present? Does this relate to a gradual worsening of the symptom itself? Has the patient developed a new perception of its relative importance (e.g. a friend told them they should get it checked out)? Do they have a specific agenda for the patient-provider encounter?
For those who favor mnemonics, the 8 dimensions of a medical problem can be easily recalled using OLD CARTS (Onset, Location/radiation, Duration, Character, Aggrevating factors, Reliving factors, Timing and Severity).


What does the mnemonic HEEADSSS stand for?
1. Home environment
2. Education, employment
3. Eating
4. Drugs
5. Sexuality
6. Suicide/depression

7. Safety from injury & violence What does the mnemonic PACES stand for?
1. Parents, peers
2. Accidents, alcohol/drugs
3. Cigarettes
4. Emotional issues
5. School, sexuality

What does the mnemonic HITS stand for?
1. Hurt
2. Insult
3. Threaten
4. Scream

What is the difference between a screening & an assessment?
1. Screening: to find out if a problem exists.
2. Assessment: the further investigation into the problem found during the screening.

What is a medical emergency?
How should you guide others?
What are various medical emergencies?
Medical emergencies as per diagnosis and treatment.
Medical emergencies as per specialties.
Medical emergencies related to symptoms, signs, statements, questions, issues, and histories that raise suspicion of a medical emergency.
What are various symptoms, signs, statements, questions, issues, and histories that should raise suspicion of a medical emergency?
What kinds of situations should be included in an organization's emergency management plans?
What tools are available for responders?
    Who has the answer?
    Who is willing to answer?
    Who has the duty and responsibility to answer?
Who should do diagnosis and treatment in emergency medical cases?
Who should practice cardiopulmonary resuscitation, advanced cardiac life support, advanced trauma life support, or endotracheal intubation in an emergency setting?
What are the differences in the duties and responsibilities of an emergency medical consultant, emergency medical doctor, nurse, and paramedic?

Does being any board-certified emergency physician guarantee correct diagnosis and treatment?
No, it is not.
Is it a medical emergency or medicolegal emergency?
What type of medical emergency or medicolegal emergency is it?

Do the symptoms, signs, statements, questions, issues, and histories fit in trauma, human pregnancy, cardiology, pulmonary, renal, gastroenteritis, neurology, ophthalmology, ear, nose & throat, pediatric, endocrinology, psychiatry, non traumatic orthopedic, or non traumatic surgical medical emergency?

Is it a trauma, human pregnancy, cardiology, pulmonary, renal, gastroenterology, neurology, Ophthalmology, ear nose and throat, pediatric, Endocrinology, psychiatry, non-traumatic orthopedic, or non-traumatic surgical medical emergency?

What is the diagnosis?
What is the treatment?
How could this be prevented?
What are medical emergencies as per specialties?

Trauma medical emergencies
Cardiology medical emergencies
Pulmonary medical emergencies
Renal medical emergencies
Gastroenterological medical emergencies
Neurological medical emergencies
Opthalmologic medical emergencies
Ear, nose & throat medical emergencies
Pediatric medical emergencies
Endocrinologic medical emergencies
Psychiatric medical emergencies
Non-traumatic orthopedic medical emergencies
Non-traumatic surgical emergencies
Human pregnancy medical emergencies
Trauma medical emergencies

What are trauma medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a trauma medical emergency?
Cardiology medical emergencies

What are cardiology medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a cardiology medical emergency?
Pulmonary medical emergencies

What are pulmonary medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a pulmonary medical emergency?
Renal medical emergencies

What are renal medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a renal medical emergency?


What are the criteria for diagnosis of acute renal failure?
When is dialysis required in acute renal failure?
When should patient with chronic renal failure be admitted to hospital and treated with emergency dialysis?
Gastroenterological medical emergencies

What are gastroenterological medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a gastroenterological medical emergency?
Neurological medical emergencies

What are neurological medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a neurological medical emergency?
Ophthalmological medical emergencies

What are ophthalmological medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as an ophthalmological medical emergency?
Ear, nose & throat medical emergencies

What are ear, nose & throat medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as an ear, nose & throat medical emergency?
Pediatric medical emergencies

What are pediatric medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a pediatric medical emergency?
Pediatric Patient History Questionnaire
Pediatric History:
Pediatric update
Endocrinological medical emergencies

What are endocrinological medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as an endocrinological medical emergency?
Psychiatric medical emergencies
What are psychiatric medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a psychiatric medical emergency?
Orthopaedic Injuries
Orthopaedic Injuries & Conditions
What are non-traumatic orthopedic medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a non-traumatic orthopedic medical emergency?
Non-traumatic surgical emergencies

What are non-traumatic surgical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a non-traumatic surgical medical emergency?
Human pregnancy medical emergencies

What are human pregnancy medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a human pregnancy medical emergency?
How do you do a diagnosis and treatment audit?
How do you determine a disability?
What are various types of disability?
How do you evaluate, diagnose, or treat a hospitalized person?
How do you audit admission to hospitals?
An annual preventative exam
Are there things about your medical care that could be better?
How do you do a death audit?
How do you assess preparedness, quality, competence, and infrastructure of emergency medical services in the state?
Medical Doctor
Should priority go to quality training of medical doctors or paramedical workers?
What should be done to improve the quality of medical doctors?
What should a medical doctor know about a medical condition?
How do you do quick assessment, diagnosis, and treatment of the patient?
How do you reach to correct diagnosis?
What should be the skills and knowledge of a medical doctor?
Q: How long will it take you to become a medical doctor?
Q: What will enhance your early completion?
Q: What is the most important duty and responsibility of a medical doctor?
Q: What's the second most important duty and responsibility of a medical doctor?
Q: What are the four most important duties of a medical doctor?
Q: What other duties and responsibilities can a medical doctor have?
What is medical malpractice?
What is the difference between allopathic medicine and homeopathic medicine?
What kind of global medical college does this world require?
Who is a surgeon?
What should be considered for treatment?
Diagnosis-specific counseling.
Diagnosis-specific physical therapy.
Diagnosis-specific prescription drugs.
Diagnosis-specific surgery if required.
Recommendations for surgery should be rare.
What medical conditions should a medical doctor be able to diagnose and treat?
All medical emergencies.
All medical disabilities.
All medical conditions without medical emergency or disability.

BLS
ACLS
BLS
Update
What should be the skills and knowledge of a paramedical worker?
How do you do a diagnosis audit?
How do you do a diagnosis and treatment audit?
How do you do a diagnosis audit?
How do you do a treatment audit?
What cases can counseling help?
What cases can physical rehabilitation help?
What cases can medication or drugs help?
What cases can a combination help?
What cases can intervention or surgery help?
In what cases are medication or drugs the only option?
In what cases are intervention or surgery the only option?
In what scenarios is "don't disturb" the best recommendation?
Even if things seem to be normal, an annual health checkup is recommended.
Expressions a doctor uses about medicine and tests
Can a medical doctor specialize in more than one specialty?
Yes.
Q: How long will it take you to become a medical doctor?
Q: What will enhance your early completion?
Q: What is the most important duty and responsibility of a medical doctor?
Q: What's the second most important duty and responsibility of a medical doctor?
Q: What are the four most important duties of a medical doctor?
Review of Systems
Does the patient have any known medical allergies?
Where and when did the patient last see a medical doctor?
Public Health
Intake Screening
more coming soon
Coding

Where and when did the patient last see a medical doctor?
What is a Symptom?
What is a Sign?
Review of Systems
Can you count from 1 to 10?
Can you count backwards from 10 to 1?
New Patient Forms

* Patient Registration Form
* Patient History Form
* Patient Record of Disclosures
* Acknowledgement of Receipt of Notice of Privacy Practices

Other Forms

* Adolescent Medicine – Patient History
* Adolescent Medicine - Parent History
* Asthma Action Plan
* Medical Record Release Form
* Modified Checklist for Autism in Toddlers (M-CHAT)
* NICHQ Vanderbilt Assessment Scale - Parent
* NICHQ Vanderbilt Assessment Scale - Teacher
* PPD Questionairre
* Refusal of Immunization Form
* School Entrance Exam Health Form
* Special Dietary Needs Form

Demographic Information Form
New Adult Patient History Form
New Pediatric Patient History Form
Notice of Privacy Practices Form
Elders
PHYSICAL EXAM ITEMS (The next few items may be performed by nursing staff in some settings)

I'm going to write you a prescription.

What cases can counseling help?
What cases can physical rehabilitation help?
What cases can medication or drugs help?
What cases can a combination help?
What cases can intervention or surgery help?
In what cases are medication or drugs the only option?
In what cases are intervention or surgery the only option?
In what scenarios is "don't disturb" the best recommendation?
Even if things seem to be normal, an annual health checkup is recommended.
Where is your emergency?
What is the number you are calling from?
What is the Emergency?
What is your name?
Is the patient conscious? (Able to talk)
Is the patient breathing NORMALLY?
Is the patient short of breath or does it hurt to breathe?
Is the patient bleeding?
Can it be controlled with pressure?
Has law enforcement been notified?

Was it a physical assault vs. sexual assault?
Is the patient bleeding?
How was the victim assaulted?
(Stabbing, gunshot or major trauma go to appropriate I card)
Where is the patient injured?
Can the patient answer your questions?

ASSAULT

Is patient alert?
Is patient breathing normally?
Where is the bleeding from?
Can it be controlled with pressure?
Can the patient answer your questions?
Is blood squirting out?
Is the patient a hemophiliac (a bleeder)?

CHEMICAL

What chemical caused the burn?
How was the patient burned?
Is the patient short of breath or does it hurt to breathe?
Is the patient having difficulty swallowing?
Where is the patient burned?

ELECTRICAL

Is the patient still in contact with the electric source?
Are they coughing?
How was patient electrocuted?
Are their nose hairs burned?
Are there burns around their mouth and nose?
Are there any other injuries?

EYE PROBLEMS / INJURIES

Is patient alert?
Is eyeball cut open or leaking fluid?
Is patient breathing normally?
Are there any other injuries?
What caused the injury?

FALL VICTIM

Is patient breathing normally?
Is the patient able to move their fingers and toes?
Is patient alert?
Is the patient bleeding?
How far did the patient fall?
What kind of surface did the patient land on?
Are there any obvious injuries? What are they?
Did the patient complain of any pain or illness just prior to the fall?

Is Rescue needed?
Is patient alert?
Does the patient respond to you and follow simple commands?
Is patient breathing normally?
What happened? Can the patient answer your questions?
What was the source of the heat or cold? Is the patient acting normal for him or her?
What was the length of exposure? If not, what is different?
Does the patient have any complaints?
Is the patient sweating profusely?
Is the patient complaining of pain? If so where? How does the patient act when he/she sits up?
Can the patient talk in full sentences?
Is the patient dizzy, weak, or feeling faint?

HEAT / COLD EXPOSURE

INDUSTRIAL ACCIDENTS

Is patient alert?
Is the patient bleeding?
Is patient breathing normally?
Are there any obvious injuries? What are they?
Do you have the amputated parts?
What part of the body has been amputated?
Can it be controlled with pressure?
Is the patient entrapped?
Is the patient able to move their fingers and toes?
Is Fire Department needed?
Is Aeromedical Evacuation needed?

STABBING/GUNSHOT/ASSAULT

When did this happen?
What part(s) of the body is injured?
Is there a weapon present?
Is there bleeding?
Is patient alert?
Is patient breathing normally?
Can it be controlled with pressure?
Is there more than one person injured?
Is there more than one wound?

TRAUMATIC INJURY

Is patient alert?
Is the patient bleeding?
Is patient breathing normally?
How was the patient injured?
Where is the patient injured?
Describe what happened.

TRAUMATIC INJURY

Is there a history of trauma within a few minutes or hours?
What is the cause of trauma?
Is trauma due to road traffic crash, assault, fall, or other cause?
If patient is able to talk, this is one of proof of airway patency and normal higher brain functions. A few more questions need to be asked to verify these findings. Are there any hazards present?
What type of vehicle(s) are involved?
Is patient alert? Describe what happened?
Is patient breathing normally?
(Consider breathing card). Are all of the patients free of the vehicle?
Did you stop or drive by?
How many patients are injured? Is anyone trapped in the vehicle?
Was anyone thrown from the vehicle?
Is Rescue needed?
Is the Fire Department needed?
Could she be pregnant?
Is patient breathing normally?
(Consider breathing Has she said she felt dizzy?
Is the pain due to an injury to the patient?
Has there been vaginal bleeding?
Has the patient vomited?
How does the patient act when he/she sits up?
Is the patient wearing a Medic Alert tag?
What is the patient complaining of?
Is the patient having difficulty swallowing?
How long ago was the patient exposed?
How does the patient act when they sit up?
Does the patient have a rash or hives? Are the symptoms getting worse?
Is the patient complaining of itching?
Is patient breathing normally?
Is the patient wearing a Medic Alert tag?
Is the pain due to an injury to the patient?
Has the patient felt dizzy or fainted?
Is the patient able to speak in full sentences?
Could the patient be having an allergic reaction?
Does the patient have to sit up to breathe?
Is the patient experiencing any other problems right now?
Has the patient ever had this problem before? them?
What was the patient doing just prior to when he/she became short of breath?
Is the patient on oxygen?

BREATHING PROBLEMS

Is patient alert?
Is patient breathing normally? (Consider breathing Is the patient sweating profusely? card)
Is the patient experiencing rapid heart rate with chest pain?
Where in the chest is the pain located?
Does the patient feel pain anywhere else? If so, where?
Does the patient have a history of rapid heart rate?
How long has the pain been present?
How does the patient act when he/she sits up?
Does the pain change when the person breathes or moves?
Is the patient weak, dizzy, or faint?
Does the patient take nitroglycerin? Have they taken it?
Has the patient ever had heart surgery or a previous heart attack?
Has the patient ever had a heart problem?
Is the patient nauseated or vomiting?

CHEST PAIN/HEART PROBLEMS

Does the patient have nitroglycerin?
If yes: Has the patient taken one?

DIABETIC PROBLEMS

Is patient alert?
Is the patient sweating profusely?
Is patient breathing normally?
Is the patient on insulin?
Is the patient complaining of any pain? Where is it How does the patient act when he/she sits up?
Are they dizzy, weak, or feeling faint?

Is patient alert?
Is patient breathing normally?
Has the patient had a recent illness or injury?
Did the headache come on suddenly or gradually?

Is patient alert?
Is the patient acting normally for him or her? If not, what is different?
Is the patient violent?
Has the patient vomited?
Is the patient having difficulty swallowing?
How old is the patient?
Is law enforcement needed?

PSYCHIATRIC/BEHAVIORAL PROBLEMS

Is patient alert?
Is patient breathing normally?
Can the patient talk to you?
Can the patient answer your questions?
Has the patient taken any drugs or alcohol?
Has the patient harmed himself?
Is patient a diabetic?
Is the patient acting in their normal manner?
Is the scene secure?
Where is the patient now?
Do you think the patient might harm himself?
Is the patient a diabetic?
Is patient alert?
Is patient breathing normally?
If child:
Describe what the patient is doing.
Has the child been sick?
Is the patient still seizing?
Does the child have a fever or feel hot?
How long has the patient been seizing? If female:
Has the patient had a seizure before?
Is the woman pregnant?
Does the patient have a medic alert bracelet on?
Is the patient a recreational drug user?
Has the patient had a recent head injury?

SICK PERSON

Is patient alert?
Is patient breathing normally?
Can I talk to the patient?
Have you checked for a medic alert tag?
If there is an alert tag, what does it say?
What is the problem?
Was the onset sudden or gradual?
Are you short of breath or is it hard to breath?
Are you feeling pain anywhere? If so where?
Do you feel light headed or dizzy?
Does the patient answer your questions?
What is the patient complaining of?
Is the patient complaining of pain?
How does the patient feel when he/she sits up?
Is the patient acting normally for him or her?
How does the patient look?
Is patient breathing normally?
What is the patient doing? Has the patient had a headache?
Has the patient had any recent injury/trauma?
Can the patient answer your questions?
How is the patient acting?
Is the patient able to speak in full sentences?
Has the patient had a stroke before?
Does the patients speech sound normal?
Is patient alert?
What was patient doing?
Is patient able to move at all?
Is patient breathing normally? (Consider breathing card)
Where exactly is the patient?
Why is the patient down?
Is patient able to talk?
Is patient alert?
Is patient breathing normally?
(Consider breathing What is the source of the contamination?
Has the patient been removed from the area or source of contamination?
Is a CO Detector activated?
What is the name of the contaminating agent?

CARDIAC ARREST

Is patient alert?
Is patient breathing normally?
Does the patient respond to you?
Does the patient move?
Are the pupils fixed and dilated?

ADULT CPR INSTRUCTIONS

Does anyone there know how to do CPR?
Do you have a cordless phone?
Is there a phone that may be closer to the patient?
Can someone there relay my instructions to you?
Do you have a cordless phone?
Is there a phone that may be closer to the patient?
Can someone there relay my instructions to you?

ARE YOU WILLING TO DO MOUTH TO MOUTH?

INFANT CPR?

Do you need help in remembering the procedures?

CHOKING

Is patient alert?
Is the patient able to speak or cry?
Is patient breathing normally?
Is the patient turning blue?
How old is the patient?
Describe the breathing.
Does the chest rise?
Does air enter freely?

Is the baby CONSCIOUS?
Is the baby breathing or crying?

INFANT CHOKING INSTRUCTIONS

-------------
Is patient alert?
Has the patient been removed from the water?
Is patient breathing normally?
Is the patient on land or in a boat?
How long was the patient under water?
What was the patient doing before the accident?
Is patient alert?
Is patient breathing normally?
(Consider breathing Is patient still in contact with the source?
Are there any other injuries? If so what are they?

PREGNANCY / CHILDBIRTH

Is patient alert?
Is patient breathing normally?
Does she feel the urge to go to the bathroom?
Is this the first pregnancy?
Was there an injury? What is it?
How far along is she? Has she had a seizure?
How long was she in labor before delivery?
Were there any complications?
How does she feel when she sits up?
Was the delivery vaginal or surgical?
Is she having cramping pains that come and go?

CHILDBIRTH INSTRUCTIONS

Has she had a baby before?
How far apart are the contractions (pains)?
How far apart are the contractions (pains)?
Less than More than More than Less than 5 Min. 5 Min. 2 Min. 2 Min.
Does she have a strong desire to push?
Does she have a strong desire to push?
------
Is patient alert?
Is patient breathing normally?
Did the patient have any complaints just before they became unconscious?
Is this the first time today the patient has been What were they?
How does the patient act when they sit up?
Have you or anyone else tried to wake the patient up?
Has the patient taken any medication or recreational Can the patient answer your questions?
Has the patient been drinking alcohol?
What was the patient doing before they became unconscious?
Does the patient have a medic alert tag?
Does the patient have any medical or surgical history?
Is anyone hurt or injured?
Are you in a position to help with the I victims?
Are there any injuries?
Where is the emergency?
How many people are injured?
What is the nature of the injuries?
Have personnel been evacuated?
Can you come and go as you please?
Have you or your family been threatened?
What are your working and living conditions like?
Where do you sleep and eat?
Do you have to ask permission to eat/sleep/go to the bathroom?

Make sure all questions are answered.
Who is filling out this form?
When was it started?
Are there any medical conditions you had that are not listed?
If you had any operation or fracture, what was the date and location, and who was the treating doctor?
If you are on any medication, what is its name, dose, and frequency of use?
When and who prescribed this medication?
What was the reason this medication was prescribed?
How long have you been taking this medication?
Did you ever pause in taking this medication?
How did stopping the medication affect you?
What is the name of the pharmacy or location you procure the medication?
What is an Emergency Medicine Doctor?

An Emergency Medicine Doctor, also known as an emergency physician, works in the emergency room of a facility and treats patients who need immediate care. Emergency physicians specialize in an advanced cardiac life support, trauma care and management of other life-threatening care. Emergency medicine doctors must be able to think quickly and remain calm during intensely stressful situations.

What skills and knowledge should an emergency medicine doctor have?

You should be able to reach a correct diagnosis and treatment of human beings.
You should be able to teach relevant workers including medical students and medical doctors.
You should be able to defend the diagnosis and treatment publicly.
You should be able to practice good character and good behavior.
You should be able to reply in a timely manner.
You should be able to reply to all questions.
You should be able to display your competence publicly by answering questions.
You should be able to elaborate a medical condition in at least 40 different questions and answers.
You should be able to prove that your services are better than other services.
You should be able to guide others by answering relevant questions.

He/she should be able to do endotracheal intubation.
He/she should be able to do cardiopulmonary resuscitation, and provide advanced cardiac life support and advanced trauma life support.
He/she should know about all emergency room medicines and equipment.
He/she should know about medical malpractice.
He/she should know about legal malpractice.
What is a medical emergency?
ER Equipment
Diagnostic Tests
ER Workers
Triage
Air Critical Care
Ground Ambulance Service
What is Emergency Medicine?
How did the field of Emergency Medicine get started?
What kind of patients do emergency physicians see?
Can I sub-specialize in something or do a fellowship as an emergency physician?
Are there any downsides to becoming and emergency physician?
Where can I find more info?
How do you do quick assessment, diagnosis, and treatment of the patient?
What are various medical emergencies?
Medical emergencies as per diagnosis and treatment.
Medical emergencies as per specialties.
Medical emergencies related to symptoms, signs, statements, questions, issues, and histories that raise suspicion of a medical emergency.
What are various symptoms, signs, statements, questions, issues, and histories that should raise suspicion of a medical emergency?
What kinds of situations should be included in an organization's emergency management plans?
What tools are available for responders?
    Who has the answer?
    Who is willing to answer?
    Who has the duty and responsibility to answer?
What does an emergency medicine physician do?
What kind of training does an emergency medicine physician need?
Who should do diagnosis and treatment in emergency medical cases?
Who should practice cardiopulmonary resuscitation, advanced cardiac life support, advanced trauma life support, or endotracheal intubation in an emergency setting?
What are the differences in the duties and responsibilities of an emergency medical consultant, emergency medical doctor, nurse, and paramedic?

Does being any board-certified emergency physician guarantee correct diagnosis and treatment?
No, it is not.
Is it a medical emergency or medicolegal emergency?
What type of medical emergency or medicolegal emergency is it?

Do the symptoms, signs, statements, questions, issues, and histories fit in trauma, human pregnancy, cardiology, pulmonary, renal, gastroenteritis, neurology, ophthalmology, ear, nose & throat, pediatric, endocrinology, psychiatry, non traumatic orthopedic, or non traumatic surgical medical emergency?

Is it a trauma, human pregnancy, cardiology, pulmonary, renal, gastroenterology, neurology, Ophthalmology, ear nose and throat, pediatric, Endocrinology, psychiatry, non-traumatic orthopedic, or non-traumatic surgical medical emergency?

What is the diagnosis?
What is the treatment?
How could this be prevented?
How do you assess preparedness, quality, competence, and infrastructure of emergency medical services in the state?
What is a Crash Cart?
How is code blue announced at your facility?
Burns
    Q: What causes burns?
    Q: How are burns classified?
    Q: What is the significance of the amount of body area burned?
    Q: How important is the location of a burn?
    Q: What are the potential complications of being severely burned?
    Q: How are burns treated?
    Q: How long does it take for burns to heal?
    Q: What is the prognosis of burn injury?
What will happen if you do not treat or manage this medical condition?
What will happen if you do not diagnose and treat a medical emergency properly?
It can lead to death.
It can lead to disability.
It can lead to other harms.
It can lead to medical malpractice.
It can lead to legal malpractice.
What are the medical conditions as per human body systems?
What are the medical conditions as per medical specialty?
What are medical emergencies as per specialties?
What are the medical conditions in alphabetical order?
What should you know about a medical condition?
What are the most common medical conditions prevalent in the communities?
Physical examination

Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. This data then becomes part of the medical record.

Routine annual physicals
Emergency Physical Examination

How do you perform the examination in a way that is complete, makes sense and yet is not awkward or prolonged?
Is it OK to mix together different areas of the exam or should each system be explored as a block?
As I am sure you've already recognized, these and many other related questions are not easy to answer. Putting together a smooth exam is, in fact, quite challenging. There is no single right way to perform a complete physical. The goal is to generate a method that works for you. Any technique, however, should:
  1. Cover all aspects of the examination such that you have a reasonable chance of identifying any pathology that might in fact be present.
  2. Be readily reproducible, allowing you to perform the exam the same way all the time.
  3. Keep patient gymnastics to a minimum (i.e. limit the number of times that the patient has to get up and down).
  4. Link together sections which, although disconnected physiologically, are connected spatially. It makes sense, for example, to integrate the cranial nerve and head and neck examinations as both involve the same region of the body.
  5. Allow you to be efficient and perform the exam with an economy of movement (i.e. minimize the number of times that you pick up and put down instruments, move from one side of the patient to the other, etc.).
It may take a fair amount of time, thought and practice before you come up with a system that works for you. I encourage you to experiment while choreographing your own moves.

What follows is not an in-depth review detailing the specifics of each area of the exam. Rather, it is simply an outline of the "mechanical events" that make up a complete physical.

  1. Wash your hands.
  2. Have the patient change into a hospital gown and take a seat at the end of the examining table. If possible, spend a few minutes simply watching them.
  3. Determine the blood pressure in both arms.
  4. Count the pulse. Measure this at both radial arteries simultaneously. Following this, examine the hands and fingers.
  5. Respiratory rate is noted while counting the pulse. Temperature is measured at the same time.
  6. Feel for axillary lymph nodes.
  7. Examine the scalp and head for any superficial abnormalities.
  8. Feel for lymph nodes in the head and neck.
  9. Have patient raise eyebrows, wrinkle forehead, close their eyes and smile (CN 7).
  10. Check sensation to touch on face; Feel temporal and masseter muscles when jaw clenched (CN 5).
  11. Assess extra occular movements (cranial nerves 3, 4, & 6).
    Check visual fields and acuity (CN 2) if appropriate.
  12. Using ophthalmoscope, check pupillary response to light (direct and indirect). Look for red reflex. Examine external structures of the eye.
  13. Perform fundoscopy. When examining the left eye you will have to walk to the left side of the body.
  14. Examine the outer and inner ears. You will again have to walk to the left side of the body to look at the left ear. Use your otoscope to view the tympanic membrane and associated structures.
  15. Examine the nose.
  16. Ask the patient to show their teeth and stick out their tongue. Using the otoscope and tongue depressor, examine the oral cavity. (CN 9, 10, 12).
  17. Check hearing acuity, Weber, and Rinne (CN 8) if appropriate.
  18. Have the patient shrug their shoulders and turn their head from side to side (CN 11).
  19. Walk behind the patient and feel the thyroid gland.
  20. Palpate the spine.
  21. Observe, palpate, percuss and auscultate the posterior lung fields as well the right middle lobe and the lingula.
  22. Walk around to the front, ask the patient to lie down, and listen to the anterior lung fields.
  23. Look at the cardiac area of the chest. Then feel for the point of maximal cardiac impulse.
  24. Auscultate the heart.
  25. Have the patient turn their head to the left and assess for jugular venous distention.
  26. Palpate the carotids.
  27. Listen over the carotids.
    *Note....Steps 19 thru 25 can be performed without ever removing your stethoscope from your ears.
  28. Observe, auscultate, percuss and palpate the abdomen.
  29. Feel for inguinal adenopathy and asses femoral and then popliteal pulses.
  30. Examine the feet, looking for edema, ulcers, discoloration, etc. Check for dorsalis pedis and posterior tibial pulses.
  31. Ask patient to sit up.
  32. Assess muscle bulk, tone and strength in lower extremities.
  33. Assess muscle bulk, tone and strength in upper extremities.
  34. Check sensation to pin prick, light touch, vibration, and position sense in feet and lower extremities if appropriate.
  35. Check sensation in upper extremities, as described for lower extremities, if appropriate.
  36. Check biceps, triceps and brachioradialis reflexes.
  37. Check achilles and patellar reflexes.
  38. Assess for Babinski.
  39. Assess cerebellar function with finger to nose and heel to shin testing.
  40. Have patient stand and then walk. Observe gait. Check for Romberg's Sign.
  41. For male patients, perform genital and rectal exam while they are standing.
  42. For female patients, perform pelvic exam.
  43. Wash your hands.