Relevant Questions

[DesertMedic66]

For my EMT program (the one I went through and the one I teach skills at) the students are asked to do a 1-3 page report on different cultures and discuss issues that EMS providers may face and provide some options that may be helpful to overcome those issues. For the report every thing from the deaf community to different religions are accepted. We had a student several years ago who did his report on an obese patient that he ran on. Some background on the student: he was a medic for several years who let his license expire and was now taking the EMT course to get back into the career. Since I can not post the whole report I will just list some of the questions that he asked the patient and why he decided to ask them.

They responded for a patient with chest pain who weighed +350KG. Once they got the chest pain under control is when he decided to ask the questions, while waiting for a list assist.

Some of the questions that were asked were: When was the last time you went outside? When was the last time you were able to look down and see your feet and penis? Besides hunger are there any other reasons why you over eat? Besides food what do you do to make yourself feel comfortable? There are several other questions.

His thinking behind asking the questions was because there is a likely hood that the patient will become a regular user of EMS.

My question is how deeply should we dig into the patients history especially about weight? Yes these questions all have answers that may be helpful to a medical provider just maybe not in the EMS world. Are these relevant questions that we should ask patients?

 

[chaz90]

I don't think it's our place to ask these questions. As you mentioned, it's not that they're not useful questions, but they have no place in EMS. We have neither the training nor the justification to ask these questions in an appropriate manner. The patient called because he had chest pain, not because he wanted to be interrogated about his weight. We should respond, treat the conditions we can, transport as appropriate (albeit with difficulty in some cases), and be done.

 

[OnceAnEMT]

Deep-history questions like those that really won't change your interventions, save for the comfort one, are not only potentially rude to the patient, they are also useless in the end. Even in the ED, the patient will be stabilized before questions like that are asked, if they are asked at all (it'd be the admitting doctor if anyone that asks). If you're not going to USE the history, don't take it. Because if you do, you're then just playing telephone.

 

[DesertMedic66]

I don't think it's our place to ask these questions. As you mentioned, it's not that they're not useful questions, but they have no place in EMS. We have neither the training nor the justification to ask these questions in an appropriate manner. The patient called because he had chest pain, not because he wanted to be interrogated about his weight. We should respond, treat the conditions we can, transport as appropriate (albeit with difficulty in some cases), and be done.

That was my response as well as the primary instructors response to the students essay

 

[Rin]

I've seen people do this same type of thing with psych patients, digging deep and playing psychologist. My thought is, it's good to provide a listening ear, but we have neither the training to uncover deep-seated emotional issues etc, nor any capacity to treat said issues.

The same with rape. Stick to questions about physical injuries you can treat and let the patient who's just trying to hold it together recount their story (hopefully) only once for the SANE nurse/police etc.

Asking invasive questions you have no capacity to treat just becomes a matter of satisfying your own curiosity and has no benefit for the patient. It's gratuitous.

 

[Angel]

i agree with everyone else. its playing psychologist and to be totally honest i have no interest in it. ill offer whatever help advice i deem appropiate (i realize this is subjective) and keep it moving

 

[vcuemt]

I dunno if I agree entirely with the idea that it's not our place to ask questions or educate our patients about what they can do to avoid having to call us in the future.

However, I know plenty of overweight EMS providers so it's kind of a heal thyself situation...