Sore throat Flashcards
Introduction
- *W**ash hands
- *I**ntroduce yourself
- *P**atient’s consent
- *E**xplain procedure/purpose for Hx
PC
“What brought you in today?”
HPC
Ask 3 open questions - let the patient tell their story
Show empathy for patient’s pain through facial expression and body language
Cough - “did you have a cough?”, “how long have you had it for?”, “did it start around the same time you noticed you have a sore throat?”, “do you bring up any phlegm when you cough?”, “do you cough at night?”, “does the cough wake you up at night?”
Fever - “did you have a fever?”, “did you measure your temperature?”, “how high was it?”
What have they already tried - “have you tried anything to help with the sore throat?”, “did it help?”
PMH
“Do you have any medical conditions?”
DH
- “Are you on any medications that have been prescribed by your doctor?”, “do you take any over the counter medications?”*
- “Do you have any allergies to any medications? What happens when you take the medication?”*
SH
Alcohol, smoking, recreational drugs (including IVDU) - “do you smoke?”, “how much do you smoke each day?”, “how long have you smoked for?”, “have you ever smoked? How much did you smoke and for how long?”(if the patient said they don’t smoke),”do you drink?”, “how much/what do you drink each day?”, “do you use recreational drugs?”, “have you ever injected drugs or shared needles with other people?”
Occupation - “do you work?”, “what do you do for work?”, “How is the sore throat affecting your work?”
Home situation - “what’s your home situation like?”, “do you need help with things like cooking, washing/cleaning yourself?”
FH
“Do you have any family history of any medical conditions?”
Examination
Asks to examine patient (G if gives 2 examples: inspect pharynx, feel of neck, check temperature)
Counselling & explanation
Explains difference between virus and bacterium - “It is likely that your sore throat is being caused by a viral infection. This is different to a bacteria.”
Suggests antibiotics have no or little benefit - “I understand why you’ve asked for antibiotics, but because a virus is very different to a bacteria, the antibiotic will have no effect on the virus”
Mentions other risks of using antibiotics - “Also, giving antibiotics for viruses, means that other bacteria already in your body will become resistant to the antibiotic, so that in the future if you need to be treated for a bacterial infection, the antibiotic won’t work”
Suggests additional medication (e.g. ibuprofen, OTC medication) - “For now, you could try painkillers like ibuprofen which you can get over the counter”
Explains likely spontaneous recovery - “It is very likely that your sore throat will get better on its own, and sometimes this can take up to 10 days from when you first noticed you had a sore throat”
Considers delayed prescription strategy - “But I will leave an antibiotic prescription at the reception for you to pick up if your sore throat does not resolve within the next 10 days. Is this ok with you?”
Safety-netting
“If you notice that you cannot swallow, are having an unusual rash, or having shortness of breath, it’s important that you come back to the surgery or call 111 for further review.”
Close consultation
“Thank you so much for speaking with me today. Before you go I’d like to give you a patient information leaflet. A great website to go to is NHS choices, which I’ll right on a piece of paper for you to take home with you.”
