Ah, you all have gotten used to not having a weekly challenge, so let's get back to basics. How about the different ways to describe skin? Instead of being crazy like some of my lab proctors in college finding the most exotic and disgusting photos, I'll send along one of my own.I know I have already turned a few stomachs with the photos of my burns, but that was about pain control and had to be done to make a point.
There is no point in this. Unless of course, you have no idea how to describe this wound in writing. Yes, that was a challenge.
You may ask questions as to specifics not clear in the photo, but having the wrist and hand in the picture gives all the info you need for size, color and location.
I have been known to add a little of my college education to a PCR narrative or two, but only when sure. So when I awoke this morning with the following mark on my forearm and my daughter asked what it was I told her and she wrinkled her face.
So my question to you is, how would you document this mark on my forearm?
You make the call.
Comments
Pt. denied any known traumatic event within the last 4 days, any medical history, allergies or medications. Pt. did, however say that he had a TB test administered approx 20 hours prior to our being called.
No coughing was observed.
E226 performed pt assessment, took vitals and obtained pt info.
Pt. was transported by Great Big Ambulance Co. to SFCRH BLS without further incident. E226 then returned to service.
Just a wild-ass EMT1 guess Hap, hope I was wrong. Good luck.
Pt. denied any known traumatic event within the last 4 days, any medical history, allergies or medications. Pt. did, however say that he had a TB test administered approx 20 hours prior to our being called.
No coughing was observed.
E226 performed pt assessment, took vitals and obtained pt info.
Pt. was transported by Great Big Ambulance Co. to SFCRH BLS without further incident. E226 then returned to service.
Just a wild-ass EMT1 guess Hap, hope I was wrong. Good luck.
Pt. denied any known traumatic event within the last 4 days, any medical history, allergies or medications. Pt. did, however say that he had a TB test administered approx 20 hours prior to our being called.
No coughing was observed.
E226 performed pt assessment, took vitals and obtained pt info.
Pt. was transported by Great Big Ambulance Co. to SFCRH BLS without further incident. E226 then returned to service.
Just a wild-ass EMT1 guess Hap, hope I was wrong. Good luck.
but in the meantime, I go with the cancelled on scene, sent in a cab... :)
but in the meantime, I go with the cancelled on scene, sent in a cab... :)
but in the meantime, I go with the cancelled on scene, sent in a cab... :)
I found your entry interesting thus I've added a Trackback to it on my weblog :)...
Pt was a nervous and hysterical wreck, crying out something about "how am I gonna run hose with this"
and
"Sweet lord!!! My career is over, Someone, anyone please help me!!"
After shouting "NOT ON MY SHIFT BUDDY"
I took him to the nearest trauma centre after activating the well known and famous SFFD Helicopter, as seen in the hit TV Show Trauma"
As I left the scene I saw him weeping into his wifes arms with his children cuddled into his legs screaming
"why Daddy, why!!!"
Oh sorry, did you want a serious answer!!
Pt was a nervous and hysterical wreck, crying out something about "how am I gonna run hose with this"
and
"Sweet lord!!! My career is over, Someone, anyone please help me!!"
After shouting "NOT ON MY SHIFT BUDDY"
I took him to the nearest trauma centre after activating the well known and famous SFFD Helicopter, as seen in the hit TV Show Trauma"
As I left the scene I saw him weeping into his wifes arms with his children cuddled into his legs screaming
"why Daddy, why!!!"
Oh sorry, did you want a serious answer!!
Owe! Typing that made it hurt.
Owe! Typing that made it hurt.
Oh....wait....you don't live/work in my state or my station. What was I thinking. OK, so here goes: Patient was assessed and advised to suck it up and stop being such a whiny b**ch.
The rest...well, we all know people like that don't we?
Oh....wait....you don't live/work in my state or my station. What was I thinking. OK, so here goes: Patient was assessed and advised to suck it up and stop being such a whiny b**ch.
The rest...well, we all know people like that don't we?
I dont know exactly where you are going with this, but I will be absolutely honest and describe what I would write in my patient report form.
Justin describes waking this morning and noticing a small blister on the inner aspect of his right forearm. Called 999 for assistance / advice.
O/A (On arrival) - Sitting in his chair, good colour, conscious alert and orientated. Appears in good spirits and is talkative.
O/E (On examination) - Small minor intact blister present with a surrounding area of erythema. No further apparent injuries to find. Justin states his pain score is 2 on 0-10 scale and has taken oral analgesia with some effect (assuming some things here mate)
all observations within normal limits and as charted.Justin describes [Insert cause of blister or unknown origin here].
Tx - Home care advice given [Unless some really odd cause which may have further ramifications] and instructed to contact his local GP (family doctor) if any further concerns.
No need for transport to hospital at this time and based on findings of examination. Respond Not Conveyed form completed and copies of paperwork left with patient.
Well thats it. If you give up any 'special' history then I may need to rewrite, but if it is caused by a scald from hot fat or other known mechanism then thats pretty much what I would write.
I dont know exactly where you are going with this, but I will be absolutely honest and describe what I would write in my patient report form.
Justin describes waking this morning and noticing a small blister on the inner aspect of his right forearm. Called 999 for assistance / advice.
O/A (On arrival) - Sitting in his chair, good colour, conscious alert and orientated. Appears in good spirits and is talkative.
O/E (On examination) - Small minor intact blister present with a surrounding area of erythema. No further apparent injuries to find. Justin states his pain score is 2 on 0-10 scale and has taken oral analgesia with some effect (assuming some things here mate)
all observations within normal limits and as charted.Justin describes [Insert cause of blister or unknown origin here].
Tx - Home care advice given [Unless some really odd cause which may have further ramifications] and instructed to contact his local GP (family doctor) if any further concerns.
No need for transport to hospital at this time and based on findings of examination. Respond Not Conveyed form completed and copies of paperwork left with patient.
Well thats it. If you give up any 'special' history then I may need to rewrite, but if it is caused by a scald from hot fat or other known mechanism then thats pretty much what I would write.
An Owieee ? For kid.
A vesicle ? For college boys.
The rest of the comments were also awesome. Thanks HM readers for giving me a good laugh or two or three!
An Owieee ? For kid.
A vesicle ? For college boys.
An Owieee ? For kid.
A vesicle ? For college boys.
The rest of the comments were also awesome. Thanks HM readers for giving me a good laugh or two or three!
The rest of the comments were also awesome. Thanks HM readers for giving me a good laugh or two or three!
On arrival pt found sitting at kitchen table complaing of moderate to severe pain in left wrist and hand. Upon examination pt found to have a small intact blister with noted redness around blister on inside of left wrist. upon further exam it is noted that patient has some cyanosis (may be shadowing but I think that's what I see) and mild swelling distal to the blister and pt is unable to move hand or fingers without severe pain. Airway patent. Pt denies difficulty breathing or swelling of tongue. No obvious swelling of face. Pt states he is having some mild abdominal cramping begining and states he is nauseated but denies vomiting PTOA (prior to our arrival). Pt does state that he is feeling light headed. Pt denies any other complaints. Upon removing pts clothes (except for his chonies ) :o) no other blisters found. Pt vitals are stable (B/P and HR slightly elevated possibly due to pain) Pt does state he was working in the yard yesterday but denies "noticing" any insect bite/stings. Pt denies and trauma or burns recently. Pt states he would have driven himself to the ER but was concerned because he was light headed.
Due to posibility of an insect/spider bite (and possible impending compartment syndrome) Pt placed on gurney with head lowered (not trendelenburg b/p stable) IV initiated and pt placed on EKG and O2 (protocol in my area for pain management) PT given Morphine @ 2mg increments titrated to effect and pt transported to nearest most "appropriate" ER.
With minimal information to go on this is the route of possibility I chose. Not knowing what area you live in I have no idea what insect threats you may have.
On arrival pt found sitting at kitchen table complaing of moderate to severe pain in left wrist and hand. Upon examination pt found to have a small intact blister with noted redness around blister on inside of left wrist. upon further exam it is noted that patient has some cyanosis (may be shadowing but I think that's what I see) and mild swelling distal to the blister and pt is unable to move hand or fingers without severe pain. Airway patent. Pt denies difficulty breathing or swelling of tongue. No obvious swelling of face. Pt states he is having some mild abdominal cramping begining and states he is nauseated but denies vomiting PTOA (prior to our arrival). Pt does state that he is feeling light headed. Pt denies any other complaints. Upon removing pts clothes (except for his chonies ) :o) no other blisters found. Pt vitals are stable (B/P and HR slightly elevated possibly due to pain) Pt does state he was working in the yard yesterday but denies "noticing" any insect bite/stings. Pt denies and trauma or burns recently. Pt states he would have driven himself to the ER but was concerned because he was light headed.
Due to posibility of an insect/spider bite (and possible impending compartment syndrome) Pt placed on gurney with head lowered (not trendelenburg b/p stable) IV initiated and pt placed on EKG and O2 (protocol in my area for pain management) PT given Morphine @ 2mg increments titrated to effect and pt transported to nearest most "appropriate" ER.
With minimal information to go on this is the route of possibility I chose. Not knowing what area you live in I have no idea what insect threats you may have.