Getting Them Through The Line
Triage: Friday, July 22nd
My final rotation on Friday was triage. It's a lot more interesting than it sounds, I promise. We do everything before they go back into medical to see the physicians and students back there. So, we started with basic vitals: blood pressure, blood glucose, temperature, respiratory rate, heart rate, and O2 saturation. I'm getting pretty good at getting a manual bp reading, though I still don't do it the way they taught us to in CPD, which may be problematic when it comes time to be tested on those.
Afterwards, we went through their personal and family history of diseases. Really basic ones, like diabetes, hypertension, cancer, kidney and liver disease, lung disease, etc. Then we went through medications. Let me tell you... some of those people were on a ton of medications. Antidepressants, statins, diuretics, metformin, thyroid medications... it's absolutely crazy. And, of course, since many of these patients don't have health insurance, they're out of their meds and haven't been taking them for several months, which means that all their health problems are uncontrolled.
For the women, we then had to get a GYN history: how many pregnancies, deliveries, miscarriages, etc they've had (I heard one woman there had something like 13 pregnancies, and another woman I talked to had some confusion as to what counted as a pregnancy and delivery-whether twins were two or one, etc), when they started menses, their last cycle, when their last pap and mammogram were (so we could refer them to women's health to get those taken care of), and so forth.
Finally, came the interviewing part. We were responsible for listing the chief complaint and history of present illness. While it certainly isn't a complete H&P, it's still good practice trying to figure out what the patient needs so that we could send them to the right tent. I had one lady who seriously came because she had something like 10 different diseases that she wanted checkups for. Not sure how much she was actually able to get done on Friday, since I was the last triage shift, but whatever floats her boat, I suppose.
I know many people think that doing triage is boring and uneventful, but really, it's still good practice and you can still meet a lot of interesting people with interesting stories. If all else had failed, I would not have minded doing triage all day. I would have gotten to see more patients and gotten a bigger overall picture of the type of people to come to RAM, rather than the snippets I ended up getting here and there.
My final rotation on Friday was triage. It's a lot more interesting than it sounds, I promise. We do everything before they go back into medical to see the physicians and students back there. So, we started with basic vitals: blood pressure, blood glucose, temperature, respiratory rate, heart rate, and O2 saturation. I'm getting pretty good at getting a manual bp reading, though I still don't do it the way they taught us to in CPD, which may be problematic when it comes time to be tested on those.
Afterwards, we went through their personal and family history of diseases. Really basic ones, like diabetes, hypertension, cancer, kidney and liver disease, lung disease, etc. Then we went through medications. Let me tell you... some of those people were on a ton of medications. Antidepressants, statins, diuretics, metformin, thyroid medications... it's absolutely crazy. And, of course, since many of these patients don't have health insurance, they're out of their meds and haven't been taking them for several months, which means that all their health problems are uncontrolled.
For the women, we then had to get a GYN history: how many pregnancies, deliveries, miscarriages, etc they've had (I heard one woman there had something like 13 pregnancies, and another woman I talked to had some confusion as to what counted as a pregnancy and delivery-whether twins were two or one, etc), when they started menses, their last cycle, when their last pap and mammogram were (so we could refer them to women's health to get those taken care of), and so forth.
Finally, came the interviewing part. We were responsible for listing the chief complaint and history of present illness. While it certainly isn't a complete H&P, it's still good practice trying to figure out what the patient needs so that we could send them to the right tent. I had one lady who seriously came because she had something like 10 different diseases that she wanted checkups for. Not sure how much she was actually able to get done on Friday, since I was the last triage shift, but whatever floats her boat, I suppose.
I know many people think that doing triage is boring and uneventful, but really, it's still good practice and you can still meet a lot of interesting people with interesting stories. If all else had failed, I would not have minded doing triage all day. I would have gotten to see more patients and gotten a bigger overall picture of the type of people to come to RAM, rather than the snippets I ended up getting here and there.