High Tech Lab
- Laura Palmer
- Jan 22, 2019
- 2 min read
This week I was in high tech lab and it was a great experience. We were introduced to the simulation mannequin and learned how to find the pulses (radial, femoral, and carotid), had an opportunity to auscultate (wheeze, crackles, etc), and learned how to use the monitor for vitals. After a quick introduction to the mannequin we were thrown into scenarios - Semester 2 style. A few of my learning points are below:
Questioning as a Tool for Differential Diagnosis
When calls are of a medical nature rather then trauma (Semester 1), it is our patient questioning that becomes the most important clues toward what may be occurring. The SAMPLE, OPQRST, and AEIOU TIPS pneumonics that were used superficially in Semester 1 are now truly relevant in Semester 2 and for the rest of our careers. One of my biggest take-aways from our Lab Tech's feedback during my first scenario was to use questioning to aid in your differential diagnosis. I was able to use this feedback during my second scenario when my patient was experiencing chest pain (a very common and vague symptom). I utilized SAMPLE and OPQRST to guide my initial questioning and then switched my questioning to rule out different possibilities of chest pain - ie. does your pain change when you breathe in and out? No? Okay, now I can rule out pleuritic chest pain. To continue improving, I am planning to review my Semester 1 patho notes tomorrow on medical conditions that involve SOB and chest pain and then I am going to write down potential questions I can use to rule out and differentiate between illnesses.
Communicating Patient Information - Put the Most Important First
The second learning point I want to highlight from our Lab Tech's feedback is the order in which we communicate patient information during our hospital patch and hospital report. We were taught in Semester 1 lab the general format for communicating this information and yesterday our Lab Tech highlighted the importance of communicating the most important information first. For example, when communicating a hospital report on a patient with chest pain, the most important vitals to communicate first are HR, BP, and RR. These vitals should be listed first and then follow with vitals that are less important to the patient's presentation. Our Lab Tech suggested using the SBAR (Situation, Background, Assessment, Recommendation) format to structure our communication. Here is a link to a video that demonstrates SBAR: https://www.youtube.com/watch?v=26NadjAnnBc I plan on utilizing this method and communicating the most important information first in all of my scenarios during lab class.
That's all for this week!
Laura
Hi Stephanie,
Thanks for sharing the PASTE pneumonic for respiratory emergencies! I hadn't heard of that one before. I especially liked the Chest Pain (from our patho class, intermittent chest pain with dyspnea is characteristic of pleurisy) Sputum question (green/brown sputum is indicative of pneumonia).
I took a picture of the pneumonic so I can refer to it in the future.
All the best,
Laura Palmer
Hey Laura, sounds like High tech lab was pretty cool getting to be able to use the mannequin for the first time and having the opportunity to be able to identify to the different types of respirations instead of always getting clear breath sounds from our classmates. It awesome that you were able to utilize the different history taking acronyms to help you narrow down your questions to get to a potential diagnosis. While we have been taught several acronyms to help us during scenarios such as OPQRST, SAMPLE, AEIOU TIPS, I found a website that provides another acronym; PASTE, to help with further identifying specific signs and symptoms when treating a patient. Here's the link: https://www.adamssafety.com/use-paste-for-deeper-assessment-when-taking-sample-history/. Best of luc…
Hey Sydney,
Thanks for reading my blog! I am glad that you found the SBAR video useful. I found a link to a written version that you could take a photo of and keep on your phone! https://www.researchgate.net/figure/Visual-overlaying-of-the-SBAR-and-IMIST-AMBO-acronyms_fig1_314452839
I am hoping during our ER clinical we will be able to observe paramedics do their handovers to the charge nurse or doctor and get a true insight into how to effectively communicate patient information!
Laura Palmer
Hey Laura! Awesome video, its super easy to get lost in all the information and that was a super helpful way to cut it all down to the basics of what we should be conveying. I will defiantly be incorporating this into my own scenarios in the future to assistant myself. Awesome job in lab!
-Kindly,
Sydney McGee