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The History

In the majority of medical cases, the basis of the paramedic's field diagnosis is the

patient history.

Always accept information from previous caregivers gratefully, but

briefly reconfirm it with the patient.

Elements of your patient questioning that will help you establish a trusting and professional relationship with the patient include:

making eye contact,
positioning yourself at the patient's eye level,
presenting a neat and clean appearance,
focusing your attention on the patient.

Using medical terminology extensively does not

help you establish a trusting and professional relationship with the patient.

It is appropriate, if not necessary, to take notes while interviewing the patient because it

is nearly impossible to remember everything important the patient tells you.

An example of an open ended question is:

"What does your pain feel like?"

An example of a closed-ended question is:

"Is your pain stabbing in nature?"

The list of possible causes for a patient's symptoms is the

differential field diagnosis.

The process of presenting the patient with an observation that he he hiding or masking the truth is called


The reason (pain, discomfort, or dysfunction) the the patient or another person summons emergency medical services is termed the:

chief complaint.

The underlying cause of the patient's pain, discomfort, or dysfunction is called the:

primary problem.

Any activity that alleviates a patient's symptoms would fit under which element of the OPQRST-ASPN mnemonic for the history of the current illness?


Which of the following is an important part of the past medical history?

surgeries or hospitalizations

A recently prescribed medication may account for medical problems because of which of the following?

allergic reaction
untoward reaction.

Allergies should be expected for all of the following:

the "caine" family,
tetanus toxoid,

Allergies should not be expected for


A patient who has smoked 21 packs of cigarettes a week for 10 years has a pack history of

30 pack/years.

Which of the following is a system examined during the review of systems?

musculoskeletal system,
hematologic system,
endocrine system

This system is not a system examined during the review of systems:

lymphatic system

You would attempt this with a patient who suddenly goes silent:

stay calm and observe for nonverbal clues.

Crying is a form of venting emotional stress; be patient

and provide a patient who is crying with supportive remarks.

An example of reflection is

repeating the patient's words.

An example of facilitation is

using "go on" or "I'm listening".

An example of clarification is

asking questions about the patient's statements.

An example of empathy is

showing you understand or feel for the patient.

An example of confrontation is

challenging a patient's statement.

Questions or statements that best apply to O (onset) include:

"Did this pain begin suddenly or gradually?" and "Were you walking or running when this pain first began?"

Questions or statements that best apply to P (provocation/palliation) include:

"Does rest lessen your pain?" and "Does deep breathing increase the pain?"

Questions or statements that best apply to Q (quality) include:

"Does this pain feel crushing in nature?" and "Describe how the pain feels."

Questions or statements that best apply to R (region/radiation) include:

"Point to where you feel pain." and "Where does this pain travel to?"

Questions or statements that best apply to S (severity) include:

"How does this compare to the worst pain you have ever felt?"

Questions or statements that best apply to T (time) include:

"When did the first symptoms begin?"

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