Presentation is loading. Please wait.

Presentation is loading. Please wait.

Writing an HPI. Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for.

Similar presentations


Presentation on theme: "Writing an HPI. Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for."— Presentation transcript:

1 Writing an HPI

2 Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”.

3 Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”. 3. Characterization

4 Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”. 3. Characterization OPPQRST Pertinent positives

5 Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”. 4. Pertinent negatives

6 Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”. 4. Pertinent negatives 3. Characterization OPPQRST Pertinent positives

7 Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago… 3. Characterization He denies any… 4. Pertinent negs

8 Mr. Smith is a 48 year old man with DM, HTN and tobacco abuse who presents with chest pain. The pain began 3 weeks ago… 3. Characterization He denies any… 4. Pertinent negs

9 Mr. Smith is a 48 year old man with DM, HTN and tobacco abuse who presents with chest pain. The pain began 3 weeks ago… 3. Characterization He denies any… 4. Pertinent negs 1. Opening sentence

10 Mr. Smith is a 48 year old man with DM, HTN and tobacco abuse who presents with chest pain. The pain began 3 weeks ago… He denies any…

11 Mr. Smith is a 48 year old man s/p appendectomy who presents with chest pain. The pain began 3 weeks ago… He denies any…

12 Mr. Smith is a 48 year old man with DM, HTN and tobacco abuse who presents with chest pain. The pain began 3 weeks ago… He denies any…

13 Mr. Smith is a 48 year old man with HIV who presents with chest pain. The pain began 3 weeks ago… He denies any…

14 Mr. Smith is a 48 year old man with HIV with recent CD4 count of 22 who presents with chest pain. The pain began 3 weeks ago… He denies any…

15 Mr. Smith is a 48 year old man with DM, HTN and tobacco abuse who presents with chest pain. The pain began 3 weeks ago… He denies any…

16 Mr. Smith is a 48 year old man with known CAD who presents with chest pain. The pain began 3 weeks ago… He denies any…

17 Mr. Smith is a 48 year old man with known CAD who presents with chest pain. The pain began 3 weeks ago… He denies any… 2. Context

18 Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 4 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. 3 weeks ago… 2. Context

19 Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 4 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. Baseline 3 weeks ago… 2. Context

20 Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 4 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. Baseline 3 weeks ago… Is pain the same as before? 2. Context

21 Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for 5-10 minutes at a time and comes on several times throughout each day. It is located in the middle of his chest and does not radiate. At its worst it is a 5/10 in severity. Resting seems to make the pain get better. He can not describe the quality further; he says “it just hurts”.

22 Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 3 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. 3 weeks ago… He denied any… 2. Context / baseline 3. Characterization 4. Pertinent negatives 1. Opening

23 Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 3 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. 3 weeks ago… He denied any… In the ED… 5. Other tests (not diagnoses) if will change management 2. Context / baseline 3. Characterization 4. Pertinent negatives 1. Opening

24

25 Mr. Smith is a 48 year old man with known CAD who presents with chest pain. He first presented with chest pain 3 years ago. Cath demonstrated 90% LAD lesion and he received a bare metal stent. He has been asymptomatic since then. 3 weeks ago… He denied any… In the ED… 5. Other tests (not diagnoses) if will change management 2. Context / baseline 3. Characterization 4. Pertinent negatives 1. Opening

26


Download ppt "Writing an HPI. Mr. Smith is a 48 year old man who presents with chest pain. The pain began 3 weeks ago and has been slowly getting worse. It lasts for."

Similar presentations


Ads by Google