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Home > Topics > Patient assessment
May 12, 2014
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The Question
by EMS1 Community

How useful is the medical history of a patient during medical emergencies?

Read the response and add your own thoughts in the comments

A question posted recently on Quora asked "How useful is the medical history of a person during medical emergencies?" Former paramedic Anderson Moorer gave his opinion on the topic. Read his response, and add your own to the comments.

It's extremely useful. It may point to the underlying cause of the symptoms visible to the medical responders; it may warn them of potential complications which informs their decisions on emergency treatment.

For instance, a young patient with difficulty breathing and cystic fibrosis may look like a young patient with asthma, or pneumonia, or a panic attack. But the cystic fibrosis patient is in great danger: the medic may decide to opt for more rapid transport where they might otherwise administer albuterol and observe its effect.

A patient in seizures who has a history of alcoholism will be treated differently from a seizing patient who suffered recent head trauma, or a patient with a history of epilepsy, or a patient who is taking blood thinners.

Similarly, the medications a patient is on matter. A man who is on painkillers and has chest pain may be harmed by the usual field treatment of administering morphine. 

And allergies are obvious ... If a patient is allergic to a medication you administer, you can kill them outright.

Infectious disease is also important information. If medics know a patient has HIV or tuberculosis they can limit exposure to themselves, bystanders, and staff in the ER.

A final note: a product or service like you mention has another important role: obtaining this information in the field takes time. A medic not only has to gather the information, look over the patient’s medications, and write it all down, but the time they spend doing so is time they can use in treatment, setting up IV lines, examining the patient etc. 

Pre-hospital care requires as much efficiency as possible because manpower is limited and time is short. Making all relevant information available immediately absolutely will save lives, as well as shorten time on scene enabling a smaller force to cover more incidents.

I should add that medics don't need lengthy detailed histories, but an up-to-date overview of the patient’s significant history, medications and allergies. A paragraph of more relevant and recent information is worth much more than a comprehensive chart nobody has time to read over.

About the author

"The Question" section brings together user-generated articles from our Facebook page based on questions we pose to our followers, as well as some of the best content we find on Quora, a question-and-answer website created, edited and organized by its community of users who are often experts in their field. The site aggregates questions and answers for a range of topics, including public safety. The questions and answers featured here on EMS1 are posted directly from Quora, and the views and opinions expressed do not necessarily reflect those of EMS1.
Comments
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Jonathan Farrow Jonathan Farrow Saturday, May 17, 2014 9:23:05 PM A: How exactly does a patient taking a painkiller going to be harmed by the usual 5 mg of morphine? B: My ambulance has two personnel, my partner usually writes down the patients demographics and medications while I do my assessment and start treatment. He reads the meds off to me so I can counter the ever present "ambulanesia" you know the old: "do you have any medical conditions?" "Nope" "So you aren"t taking lisinopril for hypertension?" "Oh ya I have hypertension" And while that conversation is going on I am hooking the patient up to the monitor. While I feel like the vast majority of Paramedics come out of school with a weak knowledge of risk factors (i.e. what constitutes a maternal familial cardiac history?) it is still important to gather as much information as possible. If you have a ten minute trip to the hospital and your patient is stable there is no reason you shouldn't spend ten minutes collecting as much history as possible. If nothing else it is good practice. I would rather take a little longer on-scene getting a thorough and adequate history so that I can properly prepare the receiving facility and make the appropriate transport decision. I have started ACS treatment from chest pain with a clean EKG, but significant risk factors. My favorite of course being: "Have your mother or father had a heart attack?" "My dad died of a heart attack at 48" "How old are you again sir?" "I'll be 47 next month" "So uh, you aren't allergic to aspirin are you?"

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