Taking a History Flashcards

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1
Q

taking a history

A

first step of taking an injury/illness evaluation

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2
Q

history

A

info described by SA about what’s going on

more subjective info attained => find root. of problem

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3
Q

“history taking” acronym

A
Onset of events
Provocation/palliation
Quality with pain
Region & radiation
Severity
Time
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4
Q

Onset of events

A

event (acute/chronic) => pain

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5
Q

“o” questions

A

what were u doing when you first noticed pain?

was there a specific event that caused pain?

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6
Q

Provocation/palliation

A

movement/ pressure/ alleviation

method making problem better/ worse

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7
Q

“p” questions

A

anything that helps alleviate the pain?
does stretching/ running/ throwing make pain better/ worse?
icing/ pain meds?

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8
Q

Quality of Pain

A
pain type (sharp, dull, achy, burning, constant, throbbing)
thus type => better idea of problem
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9
Q

“q” questions

A

can you describe pain?
sharp pain w/ any specific movement?
burning, numbness, tingling => possibly neural issues!

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10
Q

Region & Radiation

A

specific location of problem => affected structures

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11
Q

“r” questions

A

can you point w/ finger where it hurts most?

or the general area?

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12
Q

Severity of Pain

A

how bad is pain using scale

  • how debilitating pain is
  • assessment tool for treatment effectiveness
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13
Q

”s” questions

A

can you rate pain from scale from 0 to 10?

0 = no pain –> 10 = hospital rn

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14
Q

Time

A

duration of pain since onset & if its changed (better or worse)

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15
Q

“t” question

A

when did pain start?
is pain constant?
has pain changed since u noticed it?

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16
Q

after taking a history (& importance)

A

ask if there is anything else SA would like to add (before moving onto objective info)
additional missing info; show we are listening; build trust between clinician & SA

17
Q

other important questions

A

have you had same before this mvmet?
can you play thru pain?
goal with managing this issue?
did you see anyone else about this problem? what did they say?
if stretching helps pain, how is pain before/ after scale (1-10)?
family w/ similar issue?