Establishing patient presentations
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Mark, can you explain to me how we actually get to establish the patient's complaint. Are there any tips, or help that you can give us as to actually getting down to that narrative?
It is a good idea to find out what has happened and when it happened and how bad it was, really. So, for example, when somebody has an injury and they have a bandage or plaster or anything covering that injury, it is always important to look at the wound, look at the damage, looking for deformity. It is no good saying, "Well, it has been bandaged up. It is a cut. Okay." We need to know if it is bleeding, actively bleeding if the infection is setting in if it is a one-week-old injury, or a few days old. There are also problems, non-verbal communication is, I think it is like 80% of all communications, and quite often we will have people who English is not their first language. So, non-verbal communication is really important in triage. Get people to point to where it hurts, get them to show you. We can also use something called Language Line. We can use an interpreter.
What about things like dementia? Is that giving you a bigger problem these days? Can we use anything to help us with dementia patients and things like that?
I think the most important thing with dementia patients is they have somebody with them, either a family, a relative, member of the family or a carer, but they are accompanied.
So, they basically bring the chaperone along with them to act in their best interests and you use them as the interpreter, really, for that patient's care.
The carer or the family member usually knows the patient really well and can interpret what they are saying.
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