What football can teach us about patient assessment
This article, originally published October 5, 2010, has been updated
Patient assessment is a team effort that requires a plan, roles, and follow through
Football offers plenty of metaphors for just about any aspect of life. Watching my favorite football teams - college or professional - makes me think about how the huddle and coming to the line of scrimmage is much like the scene size-up of the patient assessment.
1. Receive the play
You are part of a team. The dispatcher calls in your play, but unlike a quarterback, you don’t have the luxury to audible out of a patient with persistent vomiting, lift assist, or low back pain. What you can do is set your attitude when you receive the play call, "I may not like this play, but I am going to execute this play to win" or "I am going to successfully advance this patient to the next level of care."
2. Clarify roles
The scene size-up begins with dispatch information and the minutes before you actually make patient contact. In the huddle, players receive instructions on what they will do on the play — block, run, pass, or catch.
- During the scene size-up determine who will lead?
- How will you handle multiple patients?
- Who will take the report from first responders?
3. Eliminate distractions
As players approach the line of scrimmage they tune out distractions and put their total focus on the job ahead. Once the play is called and as you approach the scene turn off the music, holster your phone, and secure your coffee cup. As you approach the patient eliminate other distractions by turning off a loud television, asking the patient to snub out their cigarette, or for the family to calm the barking dog.
4. Make adjustments
Before the ball is snapped players make adjustments to see how the defense will react. Shifts and motions expose opportunities for big gains.
I look for easy adjustments during the scene size-up that can make big gains for respiratory distress or pain management. Repositioning the airway, assisting the patient to a position for better breathing, acknowledging a painful situation, or a hand on the shoulder are easy adjustments that can be made to better understand the patient’s problem and can make big improvements before the initial assessment is even started.
5. Finally, remember the clock is ticking
Act with a sense of purpose and pace that is appropriate for the patient and their problem. You need to know the difference between running a two-minute drill and a clock-killing drive to secure victory.
Are you a football fan? What other metaphors do you see in football for patient assessment? Tell us in the comments below.