Patient assessments: How to avoid free-for-alls

Updated July 20, 2015

Is your patient assessment like a gift-giving free-for-all or officiated like mom in a Santa hat?

On Christmas morning, our kids raced into the living room, prepared to thrash their way through the pile of gifts as rapidly as possible.

Substantial cajoling and adult guidance from mom in a Santa hat was required to initiate an orderly process of taking turns, appreciating a gift after it was opened, and taking occasional pauses for a meal or to welcome additional relatives.

I also know some families that have just the opposite process; a gift-opening free-for-all.

Kids scrape through the pile for the presents with their name on the label and tear into them as rapidly as possible. In a matter of minutes, the area around the Christmas tree is covered with wrapping paper, box debris, and toy parts.

In tiered response systems, a patient can be quickly surrounded by three or four medical first responders from a fire company, a two- or three-person ambulance crew, and even a police officer.

Sometimes this leads to a patient assessment free-for-all. A bewildered patient, roughed up like a new toy in the hands of a 3-year-old, is peppered with questions and poked and prodded by responders coming at them from three different directions.

Work with your on-scene crew to determine a process where each patient assessment question or assessment is treated like a gift.

Follow an orderly process to open the gifts, pause to appreciate the importance of each gift, and make sure really significant gifts, like hypotension in a chest pain patient or low blood sugar, are announced to the whole group before the next gift opening begins.

Continue the conversation in the comments. How do you keep the patient assessment process smooth and orderly?

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