Conversation:
- Scene 1 GP: “what can I do for you today Bryan”
- Bryan “My wife sent me, I”m probably wasting your time, I”ve just not been quite right!
- Scene 2GP: ” Why is your wife worried and in what way are you not quite right?”
- Bryan “sometimes I have a strange feeling round about here”: hand on upper abdo/lower chest
- Scene 3 GP ” What does this discomfort feel like?”
- Bryan “Its like a dull ache or sometimes a burning feeling, I have tried indigestion tablets and I think they might have helped”
- Scene 4 GP “Does it go anywhere else ?”
- Bryan ” Sometimes it feels like its in my arms, sometimes its in my legs”
- Scene 5 GP: “when does this feeling come on?”
- Bryan Can be when I”m going upstairs or after my dinner”
- Scene 6 GP “do you do any exercise”
- Bryan “I play darts , I used to be very fit and play football”
- Scene 7 GP ” Thats great news, how often do you play?”
- Bryan “Oh I don”t have time now, I played when I was in my 20’s and then I injured my knee”
- Scene 8 GP: What about your diet?
- Bryan I do eat relatively healthily but I do eat takeaways due to my job”
- Scene 9 GP: lets just check your BP 150/85, says to Bryan “Thats ok, “
Pulse point
Using a methodical focussed approach when taking the patient history helps to determine the most likely cause and helps to avoid jumping to early conclusions that may be wrong. Consider your own area of practice and refer to: Bickley, L.,S.(2013) Bates Guide to Physical Examination and History Taking. Philadelphia. Wolters Kluwer Health/Lippincott & Wilkins for further reading. Common mnemonic acronyms which help to focus the history include:
- S Site
- O Onset
- C Character
- R Radiation
- A Association
- T Timing
- E Exacerbations
- S Severity
- O Onset
- L Location
- D Duration
- C Character
- A Associated signs & symptoms
- R Relieving & Aggravating factors
- T Treatment/therapies
For further illustration of using mnemonics in assessing patients, see Modules 4 & 5.
Over the past few months
The GP considers a possible…
Page last reviewed: 01 Jun 2020