EMT: Pertinent Positives & Negatives

Cardiac Arrest

- Witnessed or unwitnessed - Any CPR performed before arrival - Patient down time - Precipitating complaints +/- Trauma +/- DNR

Overdose

OPQRST / HAM +/- Altered level of consciousness +/- Shortness of breath +/- N/V/D +/- Chest pain +/- Track marks +/- ETOH (alcohol) - What substance used? - When was it taken? - How much was taken? - Why was it taken? - Respiratory effort - Pupillary status

Headache

OPQRST / HAM +/- Photophobia +/- Fever +/- Previous episodes (if yes, is this worse? How many?) +/- Altered level of consciousness?

Abdominal Pain

OPQRST / HAM +/- Shortness of breath +/- Chest pain +/- N/V/D +/- Distention +/- Rigidity +/- Guarding +/- Evisceration +/- Ecchymosis +/- Rebound tenderness +/- Masses +/- Pain on palpation +/- Pregnancy +/- Last menstrual cycle +/- Vaginal bleeding / discharges +/- Blood in urine / stool +/- Trauma

General Weakness (Sudden)

OPQRST / HAM +/- Shortness of breath +/- Chest pain +/- N/V/D +/- Neuro deficits +/- Altered level of consciousness +/- Previous episodes (if yes, is this worse? How many?) +/- Diabetes Hx - Time/duration of event

Chest Pain

OPQRST / HAM +/- Shortness of breath +/- N/V/D +/- Lung sounds +/- Coughing / Hemotypsis +/- Diminished apical pulse

Diabetic Emergency

OPQRST / HAM +/- Shortness of breath +/- N/V/D +/- Type 1 or type 2 +/- Insulin dependency +/- Insulin taken (if yes, number of units) +/- Eating after insulin taken +/- Altered level of consciousness +/- Previous episodes (if yes, is this one worse) - Blood sugar

Vaginal Bleeding

OPQRST / HAM - Amount of blood lost - Duration of bleeding - Last menstrual period +/- Pregnancy +/- N/V/D +/- Chest pain +/- Shortness of breath

CVA (Stroke)

OPQRST / HAM - Duration of symptoms +/- Shortness of breath +/- Facial droop +/- Equal pedal push/pull +/- Equal grip strength +/- Able to repeat simple sentence +/- Pupillary status +/- Altered level of consciousness +/- Trouble swallowing

Childbirth

OPQRST / HAM - Length of contractions - Time between contractions - Expected due date - Any prenatal care? - Complications expected? - Para / Gravida - Need to bear down? - Water broken? - Fluid color? - APGAR at 1 and 5 minutes after birth

Seizure

OPQRST / HAM - Witnessed? - Description of the seizure - Duration of seizure - Pupillary status +/- Shortness of breath +/- N/V/D +/- Altered level of consciousness +/- Fever (if child) +/- Seizure Hx (if so, was this similar?) +/- Peripheral cyanosis +/- Oral trauma +/- Incontinence +/- Seizure Rx (if so, compliant to meds?)

Trauma (Assault, GSW)

OPQRST / HAM - Number of GSWs - Entry/exit wound locations +/- Sucking chest wound +/- Shortness of breath +/- N/V/D +/- Altered level of consciousness

Altered Level of Consciousness

OPQRST / HAM / AEIOU-TIPS +/- ALS symptoms (CP/SOB/ETC) +/- N/V/D +/- Pupillary status +/- Trauma

Psychosis

OPQRST / HAM / AEIOU-TIPS +/- Shortness of breath +/- Hallucinations +/- Hearing voices +/- Hypoglycemia +/- Psych Hx - Patient's normal mental status - Pupillary status - Patient trying to harm self or others?

Syncope

OPQRST / HAM / AEIOU-TIPS - Witnessed? - Duration? - Precipitating events +/- Altered level of consciousness +/- Chest pain +/- Shortness of breath +/- Syncope Hx (if so, similar events?)

Head Injury

OPQRST / HAM / DCAP-BTLS / TIC +/- Shortness of breath +/- N/V/D +/- Altered level of consciousness +/- Knock out (if so, how long?) +/- Blood thinners Rx +/- Skull Fx +/- Did they cry? (for children) - Mechanism of injury - Location of injury

Motor Vehicle Collision

OPQRST / HAM / DCAP-BTLS / TIC - Chief complaint - Location in car - Description of accident (read ended, t-bone, etc) - Where car was hit - Speeds of vehicles - Condition of windshield / steering wheel - Was patient ambulatory on scene? - Head to toe trauma assessment +/- Shortness of breath +/- Head trauma +/- Level of consciousness +/- Knock out +/- Airbag deployment +/- Restraints +/- Fatalities in vehicle +/- Passenger space intrusion +/- Ejection +/- Extrication (if yes, how long did it take)

Falls

OPQRST / HAM / DCAP-BTLS /TIC /AEIOU-TIPS - Distance of the fall - Anatomical area impacted - Type of surface hit +/- Shortness of breath +/- Chest pain +/- N/V/D +/- Level of consciousness +/- Knock out +/- Seizure Hx +/- Diabetes Hx +/- Syncope Hx