Histoy taking Flashcards
In community pharmacy, WWHAM is often used to gather info. What does this stand for?
• WHO is the patient?
• WHAT are the symptoms?
• HOW long have they had symptoms?
• ACTION have they taken any action?
• MEDICATION do they take any regular meds/drugs?
What are positives for WWHAM?
• easy to remember
• provides some of the core info needed
• doesnt need specialist knowledge
what are negatives to WWHAM?
• excludes patients ideas, concerns and expectations
• misses some important info eg allergies
• u still need to follow up, probing qs
• can feel like interrogation due to closed qs
What is in the traditional medicinal model?
• Symptoms- presenting and history of presenting complaint
• systematic enquiry
• previous medical history
• drug (and treatment) history
• family history
• social and personal history
• allergies
what does the acronym ICE mean?
Ideas, concerns, expectations
What is the Disease-Illness model?
patient presents two perspectives:
• Biomedical perspective:
- symptoms, signs, pathology
• Patient perspective:
- Ideas, concerns, expectations, impact on life
Why do we consider both perspectives in the disease-illness model?
1) builds relationship
2) the traditional model doesnt explain everything
3) the patients perspective makes diagnosis more efficient and effective
4) helps us prepare for the explanation and planning stages later on
SOCRATES is used to take history of complaint- pain for example. what is this?
• Site
• Onset
• Character
• Radiation
• Associated symptoms
• Time
• Exacerbating/relieving factors
• Severity
What is Systematic enquiry/ Review of systems? (SE/RoS)
asking questions about the different body systems eg cardiovascular system
What do you ask for in previous medical history?
• other conditions
• operations
• pregnancy (not illness)
What do you ask for in drug history?
• prescribed medicines (regular, occasional, to someone else)
• inhalers, sprays, creams, patches
• OTC meds
• herbal meds
• illegal drugs aka illegal highs
What do you ask for in family history?
• any illness in family?
• genetics
What do you ask for in social history?
• lifestyle (smoking, diet, exercise)
• occupation
• living situation (house, flat, rented, homeless)
What other things should you ask about when history taking?
Female: obstetric/gynae history
Children: preg/birth history, feeding history, developmental history, school, immunisation history, ask for child health record/red book
Any: travel and sexual history if suspected STI or infectious disease
What are some red flags/key signs to look out for that could indicate something more serious?
• blood in stools, urine, or cough
• unexpected loss of weight
• night sweats
