Chest Pain History Virginia Lam Daniella Marks Philesha Walter

First things first… WIPE Check wrist band for name and date of birth

Presenting complaint Ask a nice open-ended question “So, what’s brought you in today?”

History of Presenting Complaint Site – Where: Central? Widespread? – Does it radiate? Quality – Type of pain? Dull: MI Sharp: pleuritic plan Burning: GORD – Has it changed at all? Intensity – VAS: 1/10 Time – Constant? Intermittent? – How long have you been having it? – What were you doing at the time? – Related to certain activities? Aggravating/alleviating factors – What you have done to help the pain – What makes it better? – What makes it worse? Symptoms associated with it – Cough – SOB – PND – do you wake up SOB? – How many pillows do you sleep with? Is this the first time or have you experienced this before?

Red Flags Blood anywhere? Lumps and bumps? Weight loss? If you haven’t asked already… Any cough? Shortness of breath?

Past Medical History Do you see your GP/go to hospital regularly for any condition? Have you had operation before? Have you ever been told you that you have: – Hypertension? – Diabetes? – High cholesterol? Have you been told that you have a heart condition? Have you been told that you have a lung condition?

Drugs, drugs, drugs Do you take any tablets regularly? Do you take anything over-the-counter? Any supplements? Herbal remedies? Vitamins? Do you use any recreational drug? Do you have any drug allergies? Any allergies at all?

Family history Do you know of any condition that run in your family? – Any heart problem? – Any lung condition? – Any cancer? – Any diabetes? Do you have brother/sister? How are they? Do you have children? How are they? BE EMPATHETIC! **I am sorry to hear that….**

Social history Do you work? I would like to ask you a couple of questions about your lifestyle. – Do you smoke? If yes, how much, how long… – Do you drink alcohol? If yes, how much, how long… – How would you describe your level of physical activity? (Trying to find out what they normally can do and how that’s changed) Who is at home with you? – Do you have anyone who help you out at home/are they supportive? – What type of home do you live in? (Trying to find out about stairs, mobility issues…)

Systems Review If you don’t mind, I’d like to run through a couple of yes/no-like questions with you, to get an idea about your general health. – Any headaches/fits/faints/dizziness? – Any changes in your vision? – Any changes in your hearing? – Any problems with swallowing? – Do you feel like your heart is racing? – Any pains or aches anywhere? – Any changes in your bowel movements? – Any changes in your waterworks?

ICE What is your idea about what is going on? Is that anything concerning you right now? What do you expect we can do for you?

Thank you! Is there anything I have not asked but you think it’s important? Do you have any question for me? THANK YOU! ***Wash your hands

Some words of wisdom! Try to get through the major topics: – WIPE – SQUITAS – ICE (we like to say it ASAP – ensures that you get those points If you feel like you’re running out of time, you can shorten sections to one statement questions: – Any conditions run in the family? – Anything unusual symptoms that you’d like to tell me? (Systems review)

GOOD LUCK! You’ll all be fine!