On-Scene Data Collection/Affecting Care

derekwrn

Forum Ride Along
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I would like to get some opinions on the following:
1) How much does data collected during the on-scene interview affect your care? Specifically, does having a complete medical diagnosis history, complete medication list, and allergies directly affect the care given? Does it help to guide your thought process/decisions? Has having or not having this information ever resulted in your ability to provide care in a positive way that made a significant difference, or avoided a negative outcome (IE Allergy), or conversely, have you had a situation in which care was provided that resulted in a negative outcome because of information you did not have?

2) How much time do you think is actually spent on collection of this historical/existing type of data, on average?

Thank you!
 

NomadicMedic

I know a guy who knows a guy.
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Not to sound trite, but the mnemonic, SAMPLE is designed to give you enough information to help guide your decision, making. It’s provides meds, allergies, pertinent past history and gives you some feedback on oral intake and previous events.

Without some basic information to provide a framework you would start in the dark with every patient. That’s why we teach it as part of the basic assessment strategy.

We also teach EMS providers from the very beginning to treat immediate life threats before they move into the information gathering stage. So, theoretically, it shouldn’t delay immediate care, but can help guide your decision
 

mgr22

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I would like to get some opinions on the following:
1) How much does data collected during the on-scene interview affect your care? Specifically, does having a complete medical diagnosis history, complete medication list, and allergies directly affect the care given? Does it help to guide your thought process/decisions? Has having or not having this information ever resulted in your ability to provide care in a positive way that made a significant difference, or avoided a negative outcome (IE Allergy), or conversely, have you had a situation in which care was provided that resulted in a negative outcome because of information you did not have?
In pre-ePCR times, I wouldn't even have thought of patient interviews as data collection. Effective interviews in almost any field should be more of an analog process that favors good listening skills and tailoring follow-up questions to subjects' responses. In EMS, the data collection part can be useful for QA/QI, but that's not as time-critical as vectoring toward the most important details in support of emergent care decisions.

I can't quote a study comparing outcomes when patient details are known versus not known. I expect knowing more would be better for patients and providers than knowing less, but quality of information would be more important than quantity.
 

DrParasite

The fire extinguisher is not just for show
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I would like to get some opinions on the following:
1) How much does data collected during the on-scene interview affect your care? Specifically, does having a complete medical diagnosis history, complete medication list, and allergies directly affect the care given? Does it help to guide your thought process/decisions? Has having or not having this information ever resulted in your ability to provide care in a positive way that made a significant difference, or avoided a negative outcome (IE Allergy), or conversely, have you had a situation in which care was provided that resulted in a negative outcome because of information you did not have?

2) How much time do you think is actually spent on collection of this historical/existing type of data, on average?

Thank you!
I think much of it will depend on the call. is the patient stable or unstable? will they be a transport or a refusal? There is no black and white answer, as it's all case dependent, and patient dependent.

Now, by data gathering, do you mean entering the information into the computer? or memorizing it?

If I'm working on a 2 person team, typically one person writes, while the other person treats. The person responsible for writing will typically get name, and DOB, and maybe a med list from the family, while the treating person asks your SAMPLE questions, while the other person takes notes and documents vital signs. If I'm working solo, on a flycar, or as a single responder, different situation, and less writing occurs.

That being said, if I have a patient who is not breathing, their medlist is a much lower priority than ventilating the patient. do I really care that they are allergic to penicillin? not really, because if they keep not breathing, their allergy is going to be the worse of their problems. If the guy just got shot 3 times in the chest, how important is it that I get all of his meds and allergies?
 
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